Bacterial infections as a cause of embryo- and fetopathies

Not only viruses can disrupt the normal course of pregnancy and lead to developmental disorders or even deformities in the fetus. In addition to them, embryo and fetopathy can also be caused by bacteria belonging to different groups. The first one, which we will consider, consists of bacteria belonging to the "septic" group. They are divided, in turn, into gram-positive and gram-negative microorganisms. Among gram-negative ones, it is necessary to note E. coli, Proteus, Klebsiella, which very often cause kidney and urinary tract diseases (pyelonephritis, cystitis, pyelitis, etc.) in pregnant women.

Gram-positive microorganisms, which include staphylococci, streptococci, pneumococci, etc., also very often cause embryopathies. These microorganisms penetrate the placenta from chronic foci of infection: carious teeth, chronic tonsillitis (inflammation of the tonsils), adenoids, sinusitis and frontal sinusitis (inflammation of the paranasal sinuses), inflamed uterine appendages, chronic appendicitis, pyelonephritis, etc. In addition to the placenta, these pathogens can penetrate the uterus through the vagina and then through the cervical canal.

Thus, fetopathies caused by "septic" microorganisms are divided into early (arising from their passage through the placenta in the 4th-7th months of pregnancy) and late (in the 8th-10th months). Infection in the early period may result in spontaneous abortions, and in the late period - stillbirth or premature birth; children may also be born with signs of intrauterine infection.

In newborns, intrauterine infection usually manifests itself as pneumonia, otitis, meningitis, dermatitis (skin lesions) or sepsis.

Now let's return to ascending infection. Firstly, these are chronic inflammatory diseases of the vagina and cervix (vaginitis, colpitis, cervicitis), secondly, long-term increased intrauterine pressure (the so-called increased uterine tone), thirdly, vitamin C deficiency in the body. In addition, infection is most often observed in elderly primiparous women, women who have given birth to many children, with polyhydramnios, with abnormalities in the development of the uterus (bicornuate, saddle-shaped, etc.), with gaping of the cervical canal (isthmic-cervical insufficiency). In these cases, infection of the fetus does not occur immediately. Usually, bacteria get to the fetus through the hematogenous route, initially affecting the vessels of the placenta and umbilical cord, but they can also get into the fetus's body when water is swallowed, gets into the respiratory tract, through the conjunctiva or skin. Since infection occurs in this case immediately before or during childbirth, the child may be born outwardly quite healthy. However, after some time, clinical manifestations of infection begin. The child becomes restless, refuses to breastfeed, may have suffocation attacks (asphyxia or apnea), during which he turns blue, neurological disorders may appear, clinically resembling birth trauma. Later, the symptoms become more specific and various forms of initial or generalized infection (pneumonia, meningitis, otitis, sepsis) begin to be determined.

As for statistics, bacterial infection is the cause of death of the fetus and newborn in 5-20% of cases, and maybe even higher.

Taking into account all of the above, for the purpose of prevention it is necessary to promptly sanitize all possible foci of chronic infection: treat or even remove carious teeth, have an otolaryngologist treat inflamed tonsils, maxillary and other sinuses, eliminate inflammation of the uterine appendages, pyelonephritis, cystitis, etc.

One of the causes of fetal developmental disorders is listeriosis. Listeria is a microorganism that enters the human body most often through the mouth. It can cause gastrointestinal diseases, affect glandular tissues, the genitourinary system, joints, etc. But the main thing is that it can linger in the body for a long time. And given that the body of pregnant women "loves" listeria more (a kind of tropism of listeria to the genitourinary system of pregnant women), listeriosis during pregnancy occurs even more often than it is diagnosed.

After listeria enters the body of a pregnant woman, she develops a clinical picture (usually pyelonephritis, cystitis, pyelitis, colpitis, etc.). The bacteria are carried throughout the body by the bloodstream and can penetrate through the placenta to the fetus.

If the infection occurs early in pregnancy, it most often leads to the death of the fetus and spontaneous abortion. If a woman's previous pregnancies often end in this way, this should alert doctors who should examine the woman for listeriosis.

If the infection occurs later in pregnancy, the child is born with clinical manifestations of intrauterine listeriosis: various (polymorphic) rashes on the skin, in the pharynx, larynx (usually hemorrhagic), on the tonsils, yellowing of the skin; enlarged liver and spleen. Almost always, such newborns have signs of pneumonia and cerebrovascular accident. In more severe cases, symptoms of meningitis may appear.

Since the main "reservoir" of listeria in nature are cats, dogs, rodents and other animals (the disease is a zoonotic disease), the basis of prevention can be considered compliance with basic sanitary and hygienic norms and measures, such as: washing hands with soap after contact with animals. And in general, pregnant women who have not previously had any clinical manifestations of listeriosis (miscarriage, pyelonephritis, cystitis, etc.) should avoid contact with any animals, especially if the latter roam freely on the street, in the forest, etc. You should also avoid eating raw milk or insufficiently cooked meat.

If a pregnant woman has previously had repeated miscarriages, kidney or reproductive tract diseases, had unclear feverish conditions, had stillbirths or children died immediately after birth, then it is better for such women to undergo a course of preventive treatment with antibiotics, the type, dosage and duration of use of which is determined by the doctor.

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