Infections during pregnancy

Infections during pregnancy are the diseases that women fear most because of the possible harm they can cause not only to the mother's body, but also to the child. Unfortunately, most diseases of pregnant women are caused by various infections, which, depending on the type, may not affect the child at all or may cause a congenital defect. It is the high risks of giving birth to a sick child that should prompt the idea of not only timely examination and treatment, but also prevention of such infections.

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Epidemiology

The epidemiology of the problem of infections during pregnancy is very striking, since more than 85% of miscarriages in the first trimester are caused by this factor. Among children with congenital defects, infectious diseases of women during pregnancy are in first place by the reasons for their development. Speaking about the prevalence of such pathology, only 60% of infections are diagnosed on time, this is among those women who agreed to undergo examination - diagnosis is more than 90%. The remaining 40% of undiagnosed infections during pregnancy are cases when women refused to undergo special examinations. This emphasizes the huge connection between the birth of a child with defects and the timely diagnosis of infections in a woman.

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Causes pregnancy infections

The reasons for the development of various infectious diseases during pregnancy are due to the decrease in the immunity of the pregnant woman during this period. A child is an organism that is half foreign in the composition of its DNA. Therefore, in order to maintain its normal development, it is necessary that the woman's immune system does not accept it as a foreign agent. This leads to the fact that there is a normal suppression of the immune status of the pregnant woman - and this is a risk factor for catching one or another infection faster. That is why, even if before pregnancy a woman did not often get sick even with colds, then during pregnancy this happens much more often.

The causes of the development of infections depend on their transmission route, so several groups of diseases can be distinguished that differ in the transmission route and manifestations.

First of all, it is necessary to distinguish between viral and bacterial infections. Viral infections include: measles, rubella, chickenpox, cytomegalovirus, hepatitis, herpes, HIV. Bacterial infections include ureaplasmosis, syphilis, mycoplasmosis, chlamydia, toxoplasmosis, salmonellosis and many others. It should be noted that during pregnancy, a woman can be affected by any infection, but only those that can subsequently affect the development of the fetus are taken into account.

It is necessary to distinguish that if a woman suffers from one or another pathology before pregnancy, then already during pregnancy planning all measures aimed at preventing complications in the fetus are carried out. That is, the woman treats the disease so as not to risk possible consequences later.

It often happens that some women get sick, while others do not. Why does this happen? Our immune system is unique, it retains the memory of any infectious agents that have ever entered the body. If a woman has had many infectious childhood diseases in childhood, then she is already protected from them to some extent for life. This happens because when a virus or bacteria enters, antibodies are formed that remain for life, and later, when such a virus enters again, these antibodies simply kill it immediately. But such lifelong immunity is not developed for all bacteria and viruses, so you cannot always be calm about it. For example, there is lifelong immunity to the viruses of chickenpox, rubella, measles, hepatitis A.

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Pathogenesis

The pathogenesis of the effect of infections on the fetus is that these pathogenic microorganisms pass through the feto-placental barrier, and depending on their tropism, they affect one or another organ of the fetus. For example, cytomegalovirus is a representative of the herpes virus group. It enters the woman's body and may not even cause any symptoms, while in the fetus it affects the brain with the formation of cysts there, affects the liver, visual analyzers and kidneys. This causes a violation of normal organogenesis, which can cause congenital defects in the baby.

It is necessary to know one more peculiarity - when a child is infected with any virus or bacteria at an early stage of pregnancy, in the first trimester, a huge number of congenital defects are formed. And most often, due to such a reasonable structure of human nature, a spontaneous miscarriage occurs. This is how a woman's body protects itself from the birth of such a child. Therefore, no matter how bad it sounds, a miscarriage at this stage does not always need to be saved. In any case, it is necessary to take care of yourself and avoid all risk factors for infection during pregnancy.

Pets are often the cause of infections, as they can be carriers of pathogens of many infectious diseases. Therefore, one of the risk factors for infections during pregnancy can be called contact with animals. Therefore, during pregnancy and even in the first year of a child's life, it is better to let pets live with relatives for a while.

Other causes of infection development include those that can be a factor in the transmission of infections. These include poor quality water, stale food, and we should not forget about simple contact with infected people or carriers of the infection. Sometimes, for the disease, you can simply kiss a person so that he transmits staphylococcus, or for the transmission of hepatitis B - the contact must be sexual. Therefore, you should not neglect a thorough examination before pregnancy for dangerous infections, because they often may not have manifestations.

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Symptoms pregnancy infections

When talking about the clinical picture of various infections during pregnancy, it is necessary to highlight those that pose a danger to the normal development of the child. Therefore, it is necessary to classify all infections into subgroups. First of all, it is necessary to highlight viral and bacterial infections, which is important for the approach to their treatment. The main types of infections are: dangerous infections; hidden; sexually transmitted infections; viral and intestinal infections. All of them, to one degree or another, pose a danger to the life of a woman and the health of the future baby.

Dangerous infections during pregnancy are those diseases that should be diagnosed first because of their harm to the unborn child. These infections include the so-called TORCH group. These diseases include toxoplasmosis, rubella, cytomegalovirus and herpes viruses, as well as some others.

Toxoplasmosis is a disease caused by the simplest Toxoplasma gondii. The disease is dangerous for the child only if the woman is infected during pregnancy. The pathogen is transmitted through cats, which are its carriers, or through poorly cooked meat. Symptoms of toxoplasmosis in a pregnant woman are dangerous because they do not allow diagnosing the disease. The first signs of infection often manifest as malaise, headache, muscle pain, aches throughout the body. At the same time, the body temperature rises and there may be a sore throat, nasal discharge and catarrhal phenomena. Sometimes there may be a rash on the body in the form of an allergic one. That is, the clinical picture of toxoplasmosis resembles an acute respiratory disease. Therefore, it is difficult to diagnose toxoplasmosis during pregnancy, and treatment is dangerous for the fetus.

Rubella is an acute viral disease that is transmitted by airborne droplets and poses a potential threat to the fetus due to many congenital defects. Symptoms of this disease also include fever, intoxication, and a small rash on the body. The posterior cervical and occipital lymph nodes also increase in size. When the virus enters the placenta and then the fetus, in the first trimester of pregnancy, rubella causes characteristic malformations of the hearing, vision, and heart in the child. More often, children with congenital rubella have congenital deafness, cataracts, and heart defects. This teratogenic effect of the virus has been proven, so in Ukraine, rubella in a pregnant woman is a medical indication for termination of pregnancy.

Cytomegalovirus is a disease that can be transmitted by airborne droplets, sexually and by contact. A woman may not show symptoms at all, or may have mild catarrhal symptoms with an increase in temperature. The virus has a tropism for the child's brain and liver, so when it affects the fetus, this infection causes severe brain damage in the form of ischemic lesions and cysts, as well as liver enlargement and severe jaundice with bilirubin encephalopathy.

Herpes is a virus that has a tropism for the nervous system. There are two main types - herpes labialis, which is transmitted by airborne droplets and contact, and herpes genitalis, which is sexually transmitted. Symptoms of the disease in a pregnant woman are manifested by vesicular rashes on the lips or genitals, which causes itching, burning and discomfort. If the virus enters the fetus, it initiates serious brain damage. When a woman is infected with genital herpes before the birth itself, then a decision is made about a cesarean section, because if the virus has not had time to penetrate the placenta, the child can be infected by contact when passing through the birth canal.

TORCH infections are dangerous because there is a very high probability of congenital defects in the fetus when infected with these pathogens. Symptoms can be very different when different organs are affected: cranial pathology in the form of microcephaly or hydrocephalus, heart and muscle defects, deafness, emotional disorders and various forms of intellectual impairment, cataracts, chorioretinitis, liver disease and damage.

Viral infection during pregnancy is considered more dangerous than bacterial infection, since viruses have a greater tendency to induce various mutations and penetrate the placenta better. Other diseases of viral etiology that are highly dangerous include measles, chickenpox, hepatitis B and C, and HIV.

Hepatitis B and C viruses are sexually transmitted diseases, and the disease can be transmitted to a child vertically through the placenta, at birth, or with milk during breastfeeding. In the case of intrauterine infection, the child's liver is affected, and then the brain. Severe liver damage leads to the fact that after birth, the child cannot live long due to the severity of its condition. If infection occurred during passage through the birth canal or with milk, then the child develops chronic hepatitis, which also has a poor prognosis for survival.

HIV is a virus that attacks the body's immune cells, which eventually causes complete suppression of the immune system and reduces the ability to fight any infections. The danger of the virus is that it can be asymptomatic in the body for a very long time, and only after decades, cause disease. A person may not be sick, but simply be a carrier of the virus and transmit it to others, which is even more dangerous. Symptoms of the disease caused by HIV are characterized by a set of symptoms - weight loss of more than 10% of body weight, sweating, enlarged lymph nodes and causeless diarrhea. This may lead to the idea of the possibility of AIDS. In a pregnant woman, if the virus is detected before or during pregnancy, special therapy is carried out during pregnancy, as well as treatment of the child in the first days after pregnancy - this helps to avoid the development of the disease in the child.

Sexually transmitted infections during pregnancy often pose a threat to the child due to possible repeated miscarriages. Such diseases include ureaplasmosis, gonorrhea, syphilis.

Ureaplasmosis and gonorrhea are intracellular microorganisms that, when located in the cells of the uterine epithelium, can cause miscarriage.

Syphilis is a sexually transmitted disease that poses a potential threat to the fetus due to the birth of a child with congenital syphilis. In this case, the child may have a heart defect, dental abnormalities, and other abnormalities.

Intestinal infections during pregnancy can be dangerous for the mother, as a huge amount of toxins has a negative effect on the mother's body and can also affect the child. Symptoms of intestinal infections are similar - headache, repeated vomiting and diarrhea, headache and abdominal pain, as well as dehydration. Salmonellosis and listeriosis are the most common and dangerous infections during pregnancy. They are transmitted with food or water. If the pathogen gets to the fetus, the lungs, liver, brain can be affected, and stillbirth can also occur.

Latent infections during pregnancy are those that are asymptomatic, which poses an even greater threat due to the impossibility of detecting them.

Thus, the symptoms of different infections may have different manifestations, but their potential danger is that they may not have manifestations, but at the same time initiate congenital defects in the child. This proves the need for timely diagnosis of such infections.

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Complications and consequences

The consequences of infections during pregnancy are very serious, and we are talking primarily about the life of the child. Complications that can cause infectious diseases are limited not only to congenital defects, but there may also be health problems for the baby in the future in the form of chronic forms of infections and intellectual disabilities.

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Diagnostics pregnancy infections

Timely diagnosis of any infections during pregnancy is the key to the health of not only the mother, but also the child. It is very important to diagnose the disease before pregnancy, so planning any pregnancy with a thorough examination comes to the fore. If the symptoms of the disease have already appeared during pregnancy, then the main goal is to diagnose the type of infection.

If a woman has symptoms of an acute respiratory infection, this does not mean that it is a simple flu. It is necessary to examine the woman, clarify the anamnesis, the presence of pets, and only then talk about one or another diagnosis.

The tests that must be collected can be divided into mandatory and special. Mandatory tests include a general blood test, urine test, blood sugar level, and a biochemical test if necessary. Changes that may be in such tests can be used as a basis for determining a viral or bacterial infection. A viral infection is characterized by an increase in lymphocytes, while a bacterial infection is characterized by leukocytosis with a shift in the formula to the left and an increase in young forms of leukocytes. A urine test allows you to exclude a disease of the urinary tract in the event of a rise in temperature in a woman. A biochemical blood test is necessary if a woman has jaundice to determine the level of bilirubin. This allows you to assume that the hepatitis virus is affecting you or another cause of such jaundice.

Among the special tests are those that allow you to accurately determine a particular infection. For this, a serological blood test is carried out to determine antibodies to certain infections. The level of antibodies of the immunoglobulin G and M classes is determined. In this case, special reagents are used that allow you to determine the level of these antibodies to a specific infection. If there is an increase in the level of immunoglobulins G, for example, to cytomegalovirus, then we can say that the woman was infected before childbirth and now this virus does not pose a danger to the child. But if immunoglobulins M are detected, this indicates an acute infection, that is, the woman is sick and the fetus is also at risk. Among the special tests, if sexually transmitted infections are suspected, a vaginal smear is also examined. Thanks to this, it is possible to determine the type of pathogen and its sensitivity to drugs. In the case of intestinal infections, it is necessary to conduct a stool test, which will also allow you to determine the infectious agent.

Instrumental diagnostics of infections during pregnancy is aimed at examining the condition of the fetus and its organs in order to determine how a particular infection affected the child. Therefore, an ultrasound examination of the fetus is performed, which can determine the structure of the heart, bones, and some soft tissues - which allows you to determine some congenital defects already in the first trimester. If there are any problems, then at this stage the woman can still have an abortion. Then, in the second and third trimester, the chances of detecting congenital defects using ultrasound are higher, and then you can terminate the pregnancy for medical reasons if problems arise. Sometimes invasive techniques are required, such as amniotic fluid puncture with subsequent identification of the infectious agent.

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Differential diagnosis

Differential diagnostics of infections during pregnancy should be carried out between acute respiratory diseases and viral and bacterial pathologies dangerous for the fetus, because the symptoms can be very similar. Here, the main and more accurate method can be considered a serological study, which allows you to accurately determine one or another pathogen.

In Ukraine, before pregnancy and already during pregnancy, examination for the TORCH group is not mandatory, but is always recommended by the doctor and the woman herself decides whether to conduct it or not, since this is a very expensive examination. But given the possible risks, it is necessary to emphasize the high importance of this study for timely diagnosis and treatment that will not harm the baby.

Treatment pregnancy infections

Treatment of infections during pregnancy, given the teratogenicity of drugs, can be very dangerous, but also comparing the risk and benefit - treatment is necessary to avoid serious damage to the fetus. Each disease has its own drug for treatment, which is most effective in this case.

1. Treatment of toxoplasmosis in pregnant women is carried out with a drug that is most effective for this pathogen and least harmful to the child.

Spiramycin is an antibiotic from the macrolide group, which is the drug of choice for the treatment of toxoplasmosis in pregnant women. It has the highest activity against toxoplasma, inhibiting the synthesis of proteins of its wall, but does not have a teratogenic effect. The dosage of the drug is 6-9 million IU per day, that is, one tablet two or three times a day. Side effects of spiramycin are paresthesia, impaired skin sensitivity, numbness of the hands and feet, tremor, impaired bile outflow, and dyspeptic phenomena. Precautions - do not use in cholestasis or gallstone disease.

1. Cytomegalovirus and herpes virus - do not have specific treatment, as these viral infections are not very sensitive to drugs. But with a high degree of activity of the process in a pregnant woman, interferon drugs can be used.

Viferon is an antiviral drug that contains recombinant human interferon, active against most viruses from the herpes group. It acts on cytomegalovirus, hepatitis virus, as well as some bacterial infections, and also has an immunomodulatory effect. The drug is available in the form of an ointment, gel, suppositories. For the treatment of pregnant women, the recommended method of application is in the form of rectal suppositories. The dosage of the drug is from 300,000 IU for an acute disease, the course of treatment begins with using one tablet, and then according to a special scheme. Side effects are possible: thrombocytopenia, itching at the injection site, redness, and allergies. Precautions - it is not recommended to use earlier than 14 weeks of pregnancy.

1. For the treatment of intestinal infections, the safest and at the same time most sensitive drugs are those from the 3rd or 4th generation cephalosporin group.

Cefpirome is a 4th generation antibacterial agent of the cephalosporin group. The drug has a bactericidal effect on most bacteria that cause intestinal infections. The drug has no teratogenic effect, so it can be used to treat intestinal infections in pregnant women at any time. The dosage of the drug is 200 milligrams twice a day, for at least ten days. Side effects are possible when affecting the stomach - colitis or dysbacteriosis develops, which is manifested by bloating, stool disorders. Precautions - the drug cannot be used if you are allergic to penicillin antibiotics, as well as with congenital enzyme deficiencies.

1. Such infections during pregnancy as trichomoniasis, ureaplasmosis, gonorrhea, chlamydia are intracellular parasites, so the most effective antibiotics against them are macrolides. Azithromycin is an antibacterial agent from the macrolide group, which is active against most intracellular parasites, including sexually transmitted infections. The drug penetrates the cell and blocks the work of the microbial wall, thus neutralizing the bacterium itself. The dosage of the drug is one tablet twice a day. The course of treatment is selected individually, depending on the pathogen. Side effects are possible in the form of stomach pain, dizziness, decreased blood pressure. Precautions - do not take with Wilson-Konovalov disease. Often, for complete treatment of sexually transmitted infections, it is necessary to use local treatment in the form of combination suppositories in parallel.
2. Meratin-combi is a combination product that contains two antibacterial drugs (neomycin and ornidazole), an antifungal drug (nystatin) and a hormonal drug (prednisolone). Due to this composition, it has a wide spectrum of action and, due to its local action, allows you to get rid of acute infections. The drug is available in tablet pharmacological form and the dosage is one tablet at night for a course of ten days. How to use the drug - one vaginal tablet must be inserted into the applicator and inserted into the vagina with the applicator at night. After this, you need to lie down for some time in a horizontal position for better action of the drug. Side effects are rare due to the predominantly local action of the drug, but dizziness and headache may occur, as well as local burning and itching in the vaginal area.

Thus, the main principle of treating infections during pregnancy is that the benefit of treatment should be greater than no treatment at all.

Physiotherapeutic treatment of infections is not used during the acute period, but in chronic infections and the appearance of complications (for example, adhesions), thermal procedures and electrophoresis can be used.

Vitamins are very useful for infections, because against the background of decreased immunity and the possibility of damage to the child's internal organs, additional sources of vitamins and antioxidants are needed. In this case, taking folic acid is mandatory.

Traditional treatment of infections during pregnancy

Traditional methods of treatment certainly have their preference, but only in complex treatment. The main effect of various means and medicinal plants is aimed at normalizing blood circulation in the placenta, which can suffer from the action of infections.

1. Compresses with Kalanchoe are very useful for treating sexually transmitted infections, as this plant contains many vitamins and antibacterial agents that act on bacteria and fungi. For a compress, you can use Kalanchoe juice and add a few drops of olive oil to it. From this solution, you need to make a tampon and insert it into the vagina for two hours.
2. An infusion of honey and celery grass helps to treat intestinal infections during pregnancy. To do this, celery leaves need to be washed in water, poured with boiling water and infused, and then add a spoonful of honey and drink three times a day. After the symptoms of diarrhea disappear, you need to drink kefir, which will restore the microflora.
3. Medicinal herbs are highly effective in treating chronic infections. For herbal compresses, you need chamomile leaves, oak bark and anise bark. All ingredients should be poured with water and boiled. Gauze should be soaked in this solution and a tampon inserted for twenty minutes. It is also good to do your evening toilet in this solution.

Herbal treatment of infections is also effective, in addition, such herbal teas normalize blood pressure and improve blood circulation in the placenta.

1. To prepare the medicinal tea, you need to take 50 grams of thyme, 50 grams of licorice and the same amount of alder leaves, boil it over low heat for five to ten minutes and then strain. You need to drink this tea three times a day, half a cup at a time, after which you need to lie down for a while, since dizziness may occur due to a decrease in pressure. This is not a side effect, but on the contrary, the complex action of the plants helps to increase blood flow in the placenta area.
2. You need to take 100 grams of marshmallow, cinquefoil, coltsfoot and rose hips, make tea from a liter of water and drink in small sips throughout the day. The course of treatment is four weeks.
3. Calamus root, peony root and rowan berries should be poured with dill and boiled for fifteen minutes. Then you need to let the tea cool and after half an hour you can drink this tea up to five times a day. It is especially effective against cytomegalovirus infection.
4. Infusion of dill, hops and chamomile leaves is especially effective in treating bacterial sexually transmitted infections. To prepare a medicinal tea, take ten grams of herbs, pour half a liter of water over them, and then, after it has steeped for twenty minutes, strain and drink. Dosage: about a liter of tea should be drunk per day, controlling other fluids if there is swelling.

Homeopathic treatment is also widely used because of the possibility of long-term therapy, which does not affect the fetus.

1. Lapis album is a complex homeopathic medicine that has a bactericidal and immunomodulatory effect. It is available in the form of drops and is used in a dosage of eight drops per dose. Directions for use: drip the solution into 100 milliliters of boiled water and drink half an hour before meals. The course of treatment is at least three months. Precautions: do not use if you are allergic to jasmine flowers. Side effects are rare, allergic skin reactions are possible.
2. Veratrum viridum is a homeopathic remedy that has a composition of organic agents and helps to activate the body's natural defenses, including in the fight against viral agents. The drug is used in the pharmacological form of homeopathic drops and is dosed four drops twice a day half an hour before meals at the same time. The course of treatment is three months. Side effects can be in the form of nagging pain in the lower abdomen.
3. Glononium is a homeopathic medicine used for diagnosed infections, especially to prevent chronicity in case of hepatitis virus infection. It is available in the form of drops and is used in a dosage of eight drops per dose. Directions for use: drip the solution into 100 milliliters of boiled water and drink half an hour before meals. The course of treatment can be started before pregnancy if the woman has hepatitis, with a dose of three drops, and then take eight drops during pregnancy. Precautions: it is not recommended to use the drug in women with arterial hypertension or gestosis. Side effects are rare, allergic skin reactions are possible.
4. Aurum muriaticum is an inorganic homeopathic preparation. It is used to treat intestinal infections with severe nausea and vomiting. The method of using the preparation depends on the form. The dosage for drops is one drop per year of life, and for capsules - two capsules three times a day. Side effects are possible in the form of hyperemia of the skin of the hands and feet, as well as a feeling of heat. Precautions - do not use in combination with sorbents.

Surgical treatment of infections during pregnancy can be used only if congenital malformations of the child are proven, then termination of pregnancy is possible for medical reasons. If a woman is infected in the third trimester of pregnancy, then premature birth by cesarean section is possible before the child is infected.

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Prevention

Prevention of infections during pregnancy should primarily be non-specific - every woman should take care of herself when she becomes pregnant and avoid contact with infectious patients.

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Forecast

It is necessary to be examined for the TORCH group of diseases, and if the woman has not been ill, then specific immunization should be carried out. Then the prognosis for good pregnancy development will be favorable, but in the case of a dangerous infection during pregnancy, the risk of giving birth to an unhealthy child is very high.

Infections during pregnancy are what you should be most afraid of, since any infection is a potential threat of complications for the child. Therefore, it is so important to prepare for the birth of the child, carefully examine both mom and dad, and only then think about how to maintain this desired pregnancy. If you undergo all the recommended examinations according to the terms of pregnancy, then the chances of having a healthy child are very high.

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