Chlamydia in pregnancy

The presence of a common infectious disease that arose in a pregnant woman due to a lesion of the genitourinary system with gram-negative Chlamydia trachomatis bacteria, is diagnosed as a chlamydia in pregnancy. Chlamydia is transmitted by contact and has a code on the ICD 10 - A55-A56.8, A70-A74.9 (chlamydia of the lower genitourinary tract - A 56.0-A56.2).

This infection is a serious cause for concern, so you should know what is dangerous for chlamydia in pregnancy and how it should be treated.

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Causes of Chlamydia in Pregnancy

So, as has already been said, the causes of chlamydia in pregnancy - pathogenic bacteria that enter the urino-genital organs, and urethrogenital chlamydia medicine are referred to STDs - sexually transmitted diseases. However, individual serotypes of this bacterium can get into a conjunctiva - the mucous membrane covering the inner part of the eyelid and the outer part of the eye, for example, in the pool or through a common towel.

Considering the pathogenesis of chlamydial infections, it should be borne in mind that chlamydia trachomatis, although it does not belong to obligate bacteria, but in many it parasitizes permanently in the cells of epithelial tissues, where for its existence the conditions are most comfortable. In this case, no signs of such a "neighborhood" does not manifest, and in such cases, doctors say about the carrier of the bacterium.

Attached to the membranes of cells of the mucous membranes, chlamydia penetrates the cytoplasm of the cell and takes the passive L-form, but "wakes up", that is, begins to multiply and manifests itself as an infectious agent only in conditions of the body, which are accompanied by a weakening of immunity.

It is functionally "programmed" reduction of the body's defenses during pregnancy provokes activation of chlamydia, which leads to inflammation of the mucous membranes of the urethra, vagina, cervical canal (cervical canal) or uterus.

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Symptoms of Chlamydia in Pregnancy

The clinic of chlamydial lesions has a latent character in almost 70% of cases. The first signs of activation of Chlamydia trachomatis in pregnant women are manifested by the itching of the external genitalia and burning during the process of urination.

Also, such symptoms of chlamydia in pregnancy, as pathological discharge from the vagina mucopurulent, are noted. In most cases it is chlamydia in the form of inflammation of the walls of the urethra (chlamydial urethritis).

When chlamydia affects cells of the mucosal epithelium of the vagina, it also becomes inflamed, and then chlamydial vaginitis or colpitis is diagnosed.

With chlamydial cervicitis, the inflammatory process is localized in the cervical canal, and its first signs are similar. After a short period of time, erosized or hypertrophied zones with necrosis or granulomatosis may appear on the cervical mucosa.

When the infection has risen even higher - into the uterine cavity, then the inflammation of the lining of the mucous membrane - the endometrium - can develop. Chlamydial endometritis, in addition to excretions from the cervical canal, is manifested by increased body temperature, general weakness, pain in the lower abdomen and in the lower back. The same symptoms are also observed with chlamydia-induced inflammation of the fallopian tubes (salpingitis).

Consequences of chlamydia in pregnancy

Any infection during child bearing carries a double threat to health, and chlamydia is no exception. The negative consequences of chlamydia in pregnancy affect both the mother and the fetus (the child).

Consequences for the child are associated with antenatal infection of the fetus, since chlamydia enter the bloodstream through the placenta and through the cervical canal into the amniotic fluid. This can cause placental insufficiency, delayed development of the fetus, and low weight of the baby at birth.

In more than half of the cases, the child becomes infected during childbirth, passing through the genital tracts affected by the infection. Chlamydial infection of newborns in each third case leads to neonatal conjunctivitis, and also affects mucosal respiratory system, causing respiratory chlamydia in children or neonatal pneumonia in the first three months of life.

Neonatal or chlamydial conjunctivitis of newborns is manifested during the first two weeks after the birth of the child edema of the eyelids and proteins, as well as purulent secretions from the eyes. The lack of timely and effective treatment is fraught with ulceration of the cornea and irreversible deterioration of vision. Also, the consequence of chlamydia infection from mothers can be Chlamydia trachoma (ICD 10 - A71).

Also, newborns may have an elevated level of leukocytes in the urine (leukocyturia), which is typical for urethrogenital inflammations.

Chlamydia has consequences for the pregnant woman in the form of an abortion in the early stages or the birth of a premature baby. There may also be complications of chlamydia, which concern not only the transition of urethrogenital inflammatory processes to the chronic form and lesions of the internal genital organs of the small pelvis (leading to infertility), but the infection of the mucous membranes in the airways, vessels and joints.

[10], [11]

Diagnosis of chlamydia in pregnancy

Identification of urogenital chlamydiosis and diagnosis of chlamydia in pregnancy

Is based on the manifestations of the disease with gynecological examination of patients and the determination of Chlamydia trachomatis by laboratory means.

Pregnant must pass the following tests:

• a general analysis of blood and urine,
• a blood test for TORCH infection,
• on the microflora of vaginal secretions (smear from the walls of the vagina),
• molecular PCR analysis of mucosal scraping from the urethra (for detecting chlamydia DNA),
• enzyme immunoassay (ELISA) for the presence of IgG and IgA antibodies to chlamydia.

Considering the significant number of pathogens of sexually transmitted diseases and the similarity of the symptoms of most of them, a differential diagnosis of chlamydia should be carried out without fail - so as not to take its symptoms for the manifestation of cervical erosion or dysplasia, as well as the defeat of the genital tract by trichomonads or mycoplasmosis.

[12], [13], [14], [15], [16], [17]

Treatment of chlamydia in pregnancy

To date, the treatment of chlamydia in pregnancy - according to the European guidelines for the treatment of diseases caused by Chlamydia trachomatis - is carried out in the II and III trimesters with a short-term antibiotic intake, which is prescribed only by an obstetrician-gynecologist who observes pregnancy and controls the course of treatment.

The main drugs in the therapy of chlamydia are fluoroquinolone antibiotics, and also recognized as the safest group of macrolides for pregnant antibiotics. Studies of the Center for Disease Control and Prevention (CDC) at the US Department of Health, conducted in 2005-2006, showed that the most effective and safest tablets against chlamydia in the treatment of pregnant women are Azithromycin (synonyms - Azithromycin Monohydrate, Azithromycin Dihydrate, Sumamed, Azitral, Zitrolide, Sumamecin, and others). This antibiotic-macrolide should be taken once in a dose - 1 g.

In domestic gynecology apply Erythromycin, penicillin antibiotic Amoxicillin (Amoxylat, Apo-Amoxi, Gonoform, Dedoxil, Izoltil, Ospamox and other trade names) - on a tablet (0.5 g) three times a day - throughout the week. And also the antibiotic group macrolides Jozamycin (Vilprafen).

Recommended candles from chlamydia - Geksikon, Viferon, Genferon - also should appoint a doctor after the examination of a pregnant woman. Treatment of the vagina with antiseptics should be carried out only in a medical setting.

According to doctors, the alternative treatment of chlamydia refers to self-medication and during pregnancy is unacceptable by definition. Do not risk using the remedies that homeopathy offers.

Phytotherapy is long and rarely gives a quick effect, for this reason, and treatment with herbs to start during pregnancy is not worth it. Moreover, in the formulation of broths for ingestion there are such medicinal plants that are contraindicated to pregnant women: parsley, oregano, St. John's wort, etc.

Doctors say that the best prevention of chlamydia is safe sexual contact: with a constant healthy partner, with mechanical or chemical contraception. But for a pregnant woman with an already identified clamidiosis - this is advice for the future

Chlamydia in pregnancy necessarily requires medical care, otherwise the prognosis of pregnancy may be less comforting in regard to the health of the child and the health consequences of his mother.