Intestinal infection in pregnancy

Intestinal infection during pregnancy, if not eliminated, is fraught with dangerous consequences for both the woman and the fetus. Therefore, expectant mothers should be extremely attentive to their health in order to recognize the pathological process in time and take the necessary measures. One of the main conditions for the successful bearing of a baby is to undergo a medical examination at an early stage.

A smear and urine analysis are tests that are of primary importance, since their results can reveal abnormalities, including the presence of E. coli in a woman’s body.

Acute intestinal infections (abbreviated as AII) are a group of infectious diseases that can be caused by various agents (mainly bacteria) and are manifested by pain syndrome, gastrointestinal disorders, dehydration, fever, and other pathological conditions. It is very important to detect the problem in a timely manner, conduct diagnostics, and begin treatment.

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Causes of intestinal infection during pregnancy

Intestinal infection during pregnancy manifests itself as nausea, loss of appetite, fever, flatulence, and intestinal upset (diarrhea). The causes of such a pathological process can be very different:

• chronic and acute diseases of the gastrointestinal tract;
• disorders of the pancreas;
• food allergies;
• rotavirus infections causing intestinal flu;
• food poisoning;
• helminthic infestations, etc.

Pathogenic flora, getting into the body from the environment, contributes to the progression of intestinal infection. Several types of its pathogens can be distinguished. Thus, the acute course of the disease can be caused by Pseudomonas aeruginosa, Proteus, clostridia; with bacterial damage, dysentery, escherichiosis, salmonellosis develop; food poisoning is often caused by staphylococci. There are also acute intestinal infections of viral and fungal etiology.

The primary cause of such a disease is a patient or a carrier, through whom pathogens are released into the environment (along with feces, urine or vomit). The mechanism of infection with E. coli is alimentary. The route of infection can be household, fecal-oral, or airborne. Usually, the transmission factors are food products, household items, swimming in water bodies. Often, rotavirus infection during pregnancy occurs in the form of toxicosis. Infection occurs through dirty hands, poor-quality water, contact with a patient (carrier). If there is a suspicion of the development of an intestinal infection, the pregnant woman should immediately consult a doctor for further diagnosis and prescription of competent treatment.

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Pathogenesis

An intestinal infection during pregnancy can threaten the health of the mother and child, so it is very important to identify and eliminate it in time.

Pathogenesis as a set of processes that determine the mechanisms of occurrence and features of the course of the disease consists of infectious inflammation of the intestine and the development of complications. In this case, the mucous membrane of several of its sections can be affected at once. Thus, inflammation of the duodenum is called "duodenitis", of the colon - "colitis", of the small intestine - "enteritis", of the appendix - "appendicitis". The result of the development of the pathological process is a violation of intestinal functions: poor digestion of food and accumulation of feces occurs, the amount of intestinal mucus increases, nutrients are practically not absorbed. In advanced cases, ulcers are formed, which, deeply affecting the intestinal walls, cause its rupture (perforation), which can result in peritonitis, i.e. inflammation of the peritoneum.

The mechanisms of diarrhea development as a symptom of intestinal infection include: increased secretion of electrolytes, resulting in massive fluid loss; decreased absorption of nutrients due to damage to the intestinal epithelium. Etiological agents may include protozoa, viruses, and bacteria.

To determine the clinical course of the disease and adequate treatment, it is necessary to accurately diagnose the causative agent of the intestinal infection, which can be bacterial, viral, fungal, protozoan or have a mixed etiology.

Symptoms of intestinal infection during pregnancy

Anyone can become infected with an intestinal infection, including pregnant women, especially given the reduced immunity of expectant mothers. The infection can be transmitted through contact with a sick person (for example, from an older child in the family), due to poor hygiene, eating unwashed fruits, vegetables, etc.

Signs of the disease may appear within a few hours of infection or after a few days.

In case of a mild course of the disease, the doctor may prescribe outpatient treatment, but in case of frequent vomiting (more than 5 times a day), diarrhea, high temperature, hospitalization is required.

How the disease will affect the child's condition depends on the infectious agent. Salmonellosis and toxic infections in most cases do not affect the course of pregnancy and are mild. Severe infections that cause typhoid fever, dysentery, amebiasis and have a strong impact on both pregnancy and the child (in some cases, they can lead to miscarriage) are extremely rare today and the likelihood of catching an infection of this type is very low.

Intestinal infection during pregnancy usually manifests itself immediately (in acute cases of the disease), or is disguised as signs of toxicosis (nausea, vomiting, dizziness). In most cases, the incubation period of its development is from several hours to two days.

The following symptoms of intestinal infection during pregnancy can be identified:

• loss of appetite;
• nausea;
• vomiting (often multiple);
• diarrhea;
• thirst;
• discomfort in the abdomen;
• flatulence;
• fever;
• pronounced weakness;
• blood in the stool.

The disease is characterized by two main syndromes: infectious-toxic, which is expressed in an increase in temperature and fever; and intestinal, which has signs of gastritis, enteritis, gastroenteritis, colitis, etc.

The expectant mother complains of headache, dizziness, weakness, chills, lack of appetite and general malaise. Light brown stool signals the development of an intestinal infection such as gastroenteritis, repeated watery diarrhea is an enteritis syndrome, abdominal pain with frequent bowel movements in the form of feces with mucus impurities is a common enterocolitis syndrome. In severe cases of the disease, gastroenterocolitis occurs - infection of all parts of the digestive tract.

If you have such symptoms, you need to take action immediately, as this can lead to dehydration of the entire body and progressive intoxication. Due to thickening of the blood, blood clots may appear in the veins of the legs. As a result of a decrease in the volume of circulating blood, the amount of oxytocin increases - a hormone that affects the contractile function of the uterus. This condition, unfortunately, can provoke a miscarriage or lead to premature birth. If a pregnant woman has severe poisoning (for example, mushrooms), placental penetration of the poison is possible, which can cause irreparable harm to the fetus.

Consequences

Intestinal infection during pregnancy often develops against the background of weakened immunity, since the body of the expectant mother undergoes great stress during the period of bearing the baby.

The consequences can be the most unforeseen (up to miscarriage or premature birth), especially if the case is very advanced and accompanied by repeated vomiting, diarrhea, high temperature, exhaustion of the body. E. coli is able to penetrate the placenta, which will lead to infection of the fetus, and this, in turn, to the development of intrauterine pathologies and diseases (for example, meningitis). But this only happens in severe cases, when the mother has severe intoxication. In general, a bacterial intestinal infection does not harm the fetus, since the uteroplacental barrier reliably protects the baby from the penetration of bacteria.

It should be noted that intestinal flu is quite difficult to detect in pregnant women, because its symptoms are often similar to signs of toxicosis. The main threat of rotavirus for a pregnant woman is weakening of the body and the threat of dehydration, which can negatively affect the child. Dehydration often results in a sharp lack of oxygen, which leads to miscarriage or premature birth. Therefore, it is very important to promptly carry out treatment with rehydration solutions, enzyme preparations, absorbents, and in severe cases, antibiotics.

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Complications

Intestinal infection during pregnancy is dangerous because it can become a threat to the health of the woman and the child, especially if the expectant mother develops intoxication and dehydration occurs due to severe vomiting and diarrhea. In these cases, the patient needs urgent hospitalization.

Complications that arise as a result of rapid fluid loss may affect the venous system - thickening of the blood provokes the appearance of blood clots in the lower extremities. In addition, due to a decrease in the volume of circulating blood, the concentration of oxytocin increases, and this is a direct signal for contraction of the uterus, which can cause irreversible consequences in the form of miscarriage or premature birth. Other complications include:

• dehydration shock with a critical drop in blood pressure;
• infectious toxic shock, which occurs at the onset of the disease against the background of a rapid increase in temperature and is accompanied by a high concentration of toxins;
• acute renal failure;
• inflammation of the lungs or pneumonia.

To protect herself and her child, a pregnant woman should seek medical help immediately at the first symptoms of an intestinal infection, especially if the condition worsens sharply and is accompanied by severe vomiting and fainting. Only timely diagnosis and effective treatment will protect the mother and her unborn child from danger.

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Diagnosis of intestinal infection during pregnancy

An intestinal infection during pregnancy requires immediate intervention by a medical specialist (usually an infectious disease specialist), who must correctly diagnose the disease and develop an effective treatment plan depending on the patient’s condition, the clinical picture of the disease, the results of the examination and other factors.

Diagnosis of intestinal infection during pregnancy primarily includes bacteriological examination of vomit and feces. Additionally, serological methods can be used to detect antibodies to pathogens. Before receiving laboratory tests, the doctor refers to the general clinical picture of the disease to make a preliminary diagnosis and take the necessary measures to tame vomiting, reduce temperature, eliminate intoxication, etc. The final conclusions are based on the results of blood tests, bacteriological examination of food residues, washings from dishes, etc.

Molecular genetic, virological and serological methods are used to determine rotavirus infection. Feces and blood serum are also used as materials necessary for calculating viral antigens. In order to accurately diagnose, medical research is carried out in specially equipped laboratories with the ability to perform electron microscopy or electrophoresis, which give the most accurate results.

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Tests

Intestinal infection during pregnancy is mainly diagnosed as a result of bacteriological examination. Only after a thorough examination in a medical facility will the doctor be able to prescribe the correct treatment for the patient.

To determine the type of infection, first of all, blood, urine (including flora), and stool tests are necessary. A doctor may suspect an intestinal infection in a pregnant woman based on obvious symptoms, which are often similar to signs of toxicosis, and send her for additional tests to prevent the development of the disease in time and prescribe effective treatment.

Of course, the final diagnosis will be made after laboratory confirmation. Serological methods, which are used in the case of intestinal disease, are based on the detection of specific antibodies in the blood serum. Bacteriological methods include sowing materials (vomit, feces, water samples) for research. PCR diagnostics are carried out on the basis of biological fluids (for example, L-form salmonella).

It is advisable to get tested for various infections at the stage of planning a child. At the same time, both parents should take care of their health so that no complications arise during pregnancy. At the antenatal clinic, when registering, a woman takes blood tests for TORCH infections, hepatitis B and C, HIV, and undergoes an examination for STIs. This allows timely detection of any infection in the body of the expectant mother and the necessary measures to eliminate problems related to her health.

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Instrumental diagnostics

Intestinal infection during pregnancy is diagnosed using medical methods, the choice of which depends on the nature and course of the disease, as well as the equipment of the medical institution. The doctor will prescribe the patient an examination that is most informative in each specific situation.

Instrumental diagnostics includes endoscopic, ultrasound, radiological, electrographic and electrometric methods of examining the intestines in order to identify possible pathologies that are accompanied by infection. In most cases, a pregnant woman is prescribed a comprehensive study to more fully reveal the numerous processes that occur in the body.

Colonoscopy is used to detect various diseases of the colon. The procedure is performed using a special device - a colonoscope - and allows you to determine the presence of polyps or tumors, as well as inflammatory processes, especially ulcerative colitis. The use of colonoscopy is relevant in emergency situations when a pregnant woman has intestinal bleeding.

Irrigoscopy is not recommended during pregnancy except in certain cases. This radiographic method allows for a thorough examination of the intestine (the functional state of its various sections) by introducing a contrast agent (usually barium sulfate).

Rectoscopy as one of the methods of endoscopic examination is carried out with the help of a special device (rectoscope) by inserting it into the anus. Thus, it is possible to examine the inner surface of the sigmoid and rectum.

Differential diagnostics

Intestinal infection during pregnancy is diagnosed by a doctor based on examinations that allow it to be differentiated from diseases that have similar symptoms (vomiting, fever, and loose stools). Of great importance is the anamnesis (medical history), which includes the severity of complaints, a detailed description of symptoms and the timing of their appearance, information about the presence of chronic diseases.

Differential diagnostics is based on epidemiological anamnesis data, which allows predicting the nature of the disease even before receiving laboratory test results. For example, poisoning with mushrooms, fish poisons or heavy metal salts may be accompanied by gastroenteritis syndrome, however, unlike infectious diarrhea, in such conditions the pregnant woman will not have infectious-toxic syndrome (i.e. high temperature, signs of intoxication of the body).

In Crohn's disease, intestinal neoplasms or non-specific ulcerative colitis, colitis or enterocolitis syndrome is often observed - in this case, there are blood clots in the feces. But each of the above pathologies has other specific symptoms that are characteristic only of each of them. Thus, Crohn's disease is accompanied by weight loss, prolonged, chronic diarrhea, anemia, and UC - prolonged diarrhea with blood, pain in the left side of the abdomen, etc.

A practicing physician can differentiate acute intestinal infection from acute appendicitis, intestinal obstruction, mushroom poisoning, rectal cancer, and other painful conditions. If a pregnant woman complains of severe, cramping abdominal pain, the first step should be to call an ambulance to rule out surgical pathology.

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Treatment of intestinal infection during pregnancy

Intestinal infection during pregnancy requires mandatory treatment to avoid possible complications. If the disease is mild, the first step is to remove toxins from the woman's body using absorbent drugs such as Activated Carbon, Polysorb, Smecta, Enterosgel. To replenish the volume of fluid, saline solutions (like Regidron) are used, which must be drunk frequently and in small portions until the dry mouth disappears completely. Pregnant women should not starve, so a few hours after vomiting stops, you can drink a cup of tea or eat a plate of low-fat broth with crackers. Porridges and mucous decoctions are useful in this regard.

Inpatient treatment of intestinal infection during pregnancy is necessary in severe cases when the pregnant woman does not stop vomiting, her temperature rises, and her general health deteriorates sharply. In the hospital, they will put in an IV drip to intensively remove toxins. The doctor will prescribe the necessary medical examination to identify the causative agent of the infection. The treatment regimen using medications (most often antibiotics) is based on the results of the tests. A complex of vitamins and microelements is necessary to replenish the nutrients in the body of the expectant mother.

Medicines

Intestinal infection during pregnancy often requires drug treatment. The main thing is not to neglect the disease and seek help from a doctor as soon as possible. Only an experienced medical specialist can make a correct diagnosis in order to prescribe effective treatment based on the results of a bacteriological study and identification of the main pathogen. Therapy will depend on the type of intestinal infection, the localization of inflammation, and the degree of organ damage. Most often, treatment is complex and includes antibacterial therapy and immunotherapy.

Medicines that are widely used by doctors today to treat infections in pregnant women are antibiotics: Amoxicillin, as well as Cefotaxime and penicillins. Such drugs are absolutely safe for the fetus and do not provoke the development of intrauterine defects. Furagin can be used at any stage of pregnancy, except for the period from 38 to 42 weeks. The course of treatment and the dosage of drugs are individual in each specific case. During therapy, the pregnant woman needs to take probiotics to restore the intestinal microflora.

Treatment lasts on average up to 10 days (depending on the severity). After taking the antibiotic, the pregnant woman needs to take a repeat urine test, and a little later - a bacterial culture. To strengthen the body after the antibacterial course of treatment, you should take vitamin and mineral complexes, take care of a balanced diet, increase the consumption of fresh fruits and vegetables.

For treatment, enterosorbents are used first of all - activated carbon, smecta, enterosgel, which bind and remove harmful substances from the intestines. The principle of action of such agents is based on inhibition of the process of reproduction of pathogenic flora and removal of harmful microorganisms and products of their vital activity from the gastrointestinal tract.

It is recommended to start taking enterosorbents as soon as the first signs of intestinal infection appear.

Also, in the treatment of such diseases, drugs to combat dehydration of the body are of great importance - rehydron, compotes, teas, etc. also help to replenish the loss of fluid. You need to drink often during the illness, every 15 minutes in small portions. If the disease is accompanied by severe spasms and abdominal pain, you can take no-shpa.

Other medications should be taken only as prescribed by your doctor.

As a rule, pregnant women are prescribed a course of intestinal antiseptics - Baktisubtil. If the bacterial culture reveals a certain pathogen, a specialist can prescribe special treatment.

To normalize the intestinal microflora and speed up the recovery process, probiotics are prescribed - Linex, Bifiform. Enzyme preparations can also be prescribed to improve the digestion process.

Folk remedies

Intestinal infection during pregnancy is treated not only with medications, but also with traditional medicine (most often these methods are combined).

Traditional medicine is based on the use of certain products, decoctions and herbal mixtures that will restore the intestinal microflora and reduce the negative impact of pathogenic bacteria. Below are several simple recipes that use effective means for the treatment of intestinal infections.

• Mucous decoctions of oatmeal and barley grain (40-50 grams, pour two glasses of water and leave for 3-4 hours, then cook until thickened, strain). Take 1 tablespoon throughout the day.
• A decoction of boiled rice (a cup of unpolished rice should be poured with 7 cups of water and cooked over low heat until boiled, then the decoction should be left to infuse and carefully drained). Drink 1/3 cup every 2 hours.
• Potato starch (as a sorbent): 1 teaspoon of starch should be diluted in 0.5 glasses of cold water, taken 1-2 times a day.
• Pear decoction. Finely chop the pear, pour two glasses of boiling water over it, simmer for 15-20 minutes over low heat, then leave for 3 hours and strain. Drink half a glass 4 times a day (in the morning - on an empty stomach).
• A decoction of green bean pods (dry and grind 20 grams of bean pods in a coffee grinder, brew it with 1 liter of boiling water, keep it on low heat for 10 minutes, let it brew, then strain and cool). Drink 1/3 cup at least 4 times a day. You can add dried fruits of cinnamon rose hips and common blueberries to the recipe (2 tablespoons each).

Another folk remedy is mumiyo, which is recommended to be taken before meals in a dosage of 0.5 grams three times a day for a month.

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Herbal treatment

Intestinal infection during pregnancy is successfully treated with medicinal herbs. Most often, herbal mixtures are used, the action of which is aimed at improving bowel function, removing toxins, reducing the negative impact of pathogenic microbes and bacteria.

Herbal treatment is recommended for uncomplicated cases of the disease, after consultation with your doctor.

The following recipes have proven to be particularly effective in treating intestinal infections:

• Mix cinquefoil rhizome, alder cones and nettle root (a pinch each) with 0.5 l of boiling water and evaporate in a water bath for 10-15 minutes. Infuse for 2 hours, then take 100 g of the product 30 minutes before meals three times a day.
• The collection of marshmallow root, lady's mantle and wormwood is prepared and consumed in the same way as the previous one.
• Mix dried blueberries with medicinal burnet and knotweed rhizome in equal proportions, cook in a water bath, leave for a couple of hours and use as indicated above.
• Mix knotweed with plantain leaves, deadnettle and silverweed. Pour 200 ml of boiling water over 10 g of the resulting mixture and leave for half an hour. Take 2-3 times a day before meals in a dosage of 60 g.
• Oak bark decoction (boil 40 grams of oak bark in 1 liter of water, drink the resulting decoction hot - 100 g at least 5-6 times a day).

Rotavirus infection, not accompanied by fever, is well treated with a decoction of the root of the avens: boil 50 grams in 1 liter of water for 30 minutes, cool, drink 5-6 times a day.

You can brew lungwort or bird cherry fruits (pour boiling water over 20 g of raw material, leave for 20 minutes and take 100 g three times a day). It should be remembered that herbal treatment is contraindicated in the presence of pollinosis - an allergy associated with flowering plants. Therefore, expectant mothers should be careful about their use.

Homeopathy

Intestinal infection during pregnancy is treated with homeopathic medicines, which have a beneficial effect on the functioning of internal organs, increase immunity, have antibacterial properties and restore intestinal microflora.

Homeopathy should be used taking into account the individual clinical picture. For diarrhea (regardless of its cause), you can use such drugs as Camphora (Camphor tree), Veratrum album (White hellebore), Arsenicum album (of course, after consulting a doctor).

China is suitable for replenishing biological fluids in severe diarrhea. This preparation is especially effective in diarrhea accompanied by bloating. Iris versicolor is a good homeopathic remedy for problems with the pancreas, which cause diarrhea and abdominal pain, nausea and vomiting of mucus. Important medicines are also Phosphorus, Acidum phosphoricum, Thuja.

Sporobacterin suppresses the development of opportunistic and pathogenic bacteria, and is used to treat acute bacterial intestinal infections. Enterofuril suppresses the activity of harmful bacteria and is well combined with antibiotics. Bifidum-bacterin and Baktisubtil restore intestinal microflora and are effective in dysbacteriosis.

Prevention

Intestinal infection during pregnancy most often occurs against the background of weakened immunity. Therefore, it is better to prevent the disease than to allow its development. A pregnant woman needs to take care of her health, first of all, for the sake of the future baby.

Prevention of intestinal infections consists of following these rules:

• Daily observance of personal hygiene rules (cleanliness of hands and body).
• Drinking quality water (preferably boiled, purified, mineral).
• Fruit and vegetable washing mode (first under running water, then pour boiling water over them).
• Thermal processing of food.
• Maintaining the cleanliness of the home (especially the bathroom and toilet).
• Protection of food products from flies and rodents.
• Frequent ventilation of the room.
• Refusal to purchase products in unauthorized retail locations.

Pregnant women should carefully monitor their diet, especially in hot weather, when the risk of catching an infection increases significantly. Perishable products must be kept in the refrigerator. Food must be extremely fresh, without any harmful substances. Mushrooms, especially those picked by hand, are not recommended for consumption. Infection can also occur when swimming in open water. Therefore, you can only swim in designated areas, while avoiding getting water in your mouth.

Forecast

Intestinal infection during pregnancy is dangerous because it can provoke dangerous complications, so it is important for the expectant mother to take timely measures and be sure to seek medical help. The first symptoms (nausea, dizziness, diarrhea, vomiting) should alert the pregnant woman. If the condition worsens sharply, an ambulance should be called.

The prognosis can be both favorable, i.e. leads to a full recovery, and unfavorable (occurrence of complications, formation of a chronic form of the disease or carriage). With a competent approach to the treatment of rotavirus infection, you can achieve quick results - in 3-5 days the symptoms will gradually pass, and the pregnant woman's well-being will improve significantly.

The outcome of an intestinal infection may be the development of gastrointestinal pathologies in the form of intestinal dysbacteriosis, functional dyspepsia, pancreatic dysfunction, and biliary tract disorders. In order to prevent the development of complications, it is necessary to retake tests and undergo a bacteriological study, which will show whether there is a pathogen in the woman's body (for example, E. coli). Strict adherence to the recommendations and prescriptions of the attending physician will help defeat the disease and save the baby.

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