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Bacterial infections as the cause of embryo and fetopathies

 
, medical expert
Last reviewed: 19.10.2021
 
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Not only viruses are able to disrupt the normal course of pregnancy and lead to developmental disorders or even deformities in the fetus. Besides them, embryos and fetopathies can also cause bacteria belonging to different groups. The first, which we will consider, are bacteria belonging to the "septic" group. They are divided, in turn, into gram-positive and gram-negative microorganisms. Among Gram-negative, Escherichia coli, Proteus, Klebsiella, which very often cause kidney and urinary tract diseases (pyelonephritis, cystitis, pyelitis, etc.) are very common in pregnant women.

Gram-positive microorganisms, which include staphylococci, streptococci, pneumococci, etc., also very often become the cause of embryopathy. 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 appendages of the uterus, 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 (occurred during their passage through the placenta for 4-7 months of pregnancy) and late (8-10x months). When infected in the early period, spontaneous abortions may occur, and in late - stillbirth or premature birth; children with signs of intrauterine infection may also be born.

In newborns, intrauterine infection is usually manifested by pneumonia, otitis media, meningitis, dermatitis (skin lesions) or sepsis.

Now back to the ascending infection. First, chronic inflammatory diseases of the vagina and cervix (vaginitis, colpitis, cervicitis), secondly, the long-lasting increased intrauterine pressure (the so-called increased uterine tone), and third, the lack of vitamin C in the body. In addition, the most common infection is observed in elderly primiparous, multiplying women, with polyhydramnios, with anomalies of the development of the uterus (bicorne, saddle, etc.), with the cervical canal gap (ischemic-cervical insufficiency). In these cases, infection of the fetus does not occur immediately. Usually, bacteria get to the fetus by the hematogenous way, first hitting the vessels of the placenta and the umbilical cord, but they can enter the fetus also when ingesting water, getting them into the respiratory tract, through the conjunctiva or the skin. Since infection occurs in this case immediately before childbirth or during them, the child can be born apparently healthy. However, after a while he begins clinical manifestations of infection. The child becomes restless, refuses from the breast, he may have attacks of suffocation (asphyxia or apnea), in which he turns blue, neurological disorders may appear, reminiscent of a clinic trauma. In the future, the symptoms become more specific and different forms of initial or generalized infection (pneumonia, meningitis, otitis, sepsis) begin to be determined.

As for statistical data, bacterial infection causes fetal and newborn death in 5-20% of cases, and maybe even higher.

Considering all of the above, for the purpose of prevention, it is necessary to timely sanitize all possible foci of chronic infection: to treat or even remove carious teeth, to treat the otolaryngologist with inflamed tonsils, maxillary sinuses and other sinuses of the nose, eliminate inflammation of the uterine appendages, pyelonephritis, cystitis, etc.

One of the causes of the development of the fetus is listeriosis. Listeria is a microorganism that penetrates the human body most often through the mouth. It can cause diseases of the gastrointestinal tract, affect glandular tissues, genitourinary system, joints, etc. But the main thing is that it can stay in the body for a long time. And given that the organism of pregnant Listeria "loves" more (a kind of tropism of listeria to the urogenital system of pregnant women), then listeriosis is even more common in pregnancy than it is diagnosed.

After the penetration of listeria into the body of a pregnant woman, she develops a clinical picture (usually pyelonephritis, cystitis, pyelitis, colpitis, etc.). With the current of blood, bacteria are carried throughout the body and can penetrate the placenta to the fetus.

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

If the infection occurred later in pregnancy, the child is born with clinical manifestations of intrauterine listeriosis: a different (polymorphic) rash on the skin, in the throat, larynx (more often hemorrhagic), tonsils, icteric skin; enlargement of the liver and spleen. Almost always, these newborns have signs of pneumonia and cerebral circulation disorders. In more severe cases, symptoms of meningitis may appear.

Since the main "reservoir" of listeria in nature is cats, dogs, rodents and other animals (the disease belongs to zooanthroponosis), then the basis of prevention can be attributed to the observance of basic sanitary and hygienic norms and measures, such as: washing hands with soap after contact with animals. And in general, pregnant women, who previously had no clinical manifestations of listeriosis (miscarriage, pyelonephritis, cystitis, etc.), it is desirable to exclude contact with any animals, especially if the latter freely walk in the street, in the forest, etc. Do not also eat raw milk, not enough thermally processed meat.

If the pregnant woman previously had repeated miscarriage, kidney or genital tract disease, unclear febrile conditions were observed, stillbirths or children died immediately after birth, then it is better for such women to undergo a course of preventive antibiotic treatment, the kind, dosage and duration of which the doctor determines.

trusted-source[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14]

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