Two cherished stripes on the test, boundless happiness from the mere thought of future motherhood, the upcoming visits to the women's consultation and many directions for analysis ... Yes, undoubtedly, exhausting, but in the struggle for a healthy baby, all these procedures are simply necessary, and you need to treat them with maximum responsibility, so that later it would not be painfully painful.
Chronic diseases of a woman, the signs of which are invisible in the ordinary state, can "float to the surface" during pregnancy, and the insidiousness of a dangerous intrauterine infection is often just a hidden symptom. That's why physicians are strongly advised at the pregnancy planning stage to undergo an infection test, even if the expectant mother feels completely healthy. After all, their effects during pregnancy are different - from violations of its development to the termination of pregnancy or the birth of a child with severe forms of pathology. And the treatment of intrauterine infections during pregnancy is complicated due to the restriction of the choice of possible drugs for use by pregnant women.
Intrauterine infection (VUI) is the infection of the fetus or newborn viruses, bacteria, other microorganisms in utero (through the placenta, less often - amniotic fluid) or during passage through infected birth canal. In most cases, the source of infection - the mother's body, its chronic diseases of the genitourinary system (erosion of the cervix vaginitis, endocervicitis, pyelonephritis, inflammation of the uterine appendages, etc.). At the same time, the risk of developing VUI increases with primary infection by one or another pathogen during pregnancy. Also, with a minimal degree of probability, the causes of intrauterine infection may be invasive methods of pregnancy studies: amniocentesis, placentocentesis, the introduction of various medications through the umbilical cord, and the like.
To the pathogens that lead to the most serious pathologies, include infections TORCH-complex:
- toxoplasma (toxoplasma);
- others (other infections, which include syphilis, chlamydia, enterovirus infection, hepatitis A, B, gonococcal infection, listeriosis, probable measles, mumps);
- rubella (rubella);
- cytomegalovirus (cytomegalovirus);
- herpes (herpes).
Let us examine in more detail the main types of intrauterine infections caused by these pathogens:
- Toxoplasmosis or the so-called "dirty hand disease" is excited by a parasite of toxoplasma, which multiplies in the acute period of infection in the cells of humans, birds and animals. Infection often occurs by contact with infected parasite faeces of cats, soil, with the use of raw meat, unwashed vegetables and fruits, less often - with blood transfusions. The mode of transmission of infection is exclusively transplacental: from mother to fetus. This parasitic disease can be diagnosed by blood analysis and specific treatment during pregnancy with an antibiotic containing spiramycin, which helps to reduce the risk of VUI development in the fetus to 1%.
- In order to prevent intrauterine infections caused by the rubella virus , at the stage of pregnancy planning it is necessary to pass an analysis for the presence of persistent immunity to this disease. Infection during pregnancy, especially in the first trimester, is very dangerous because of the lack of effective treatment and the high probability of congenital malformations of the fetus. The risk of miscarriage and fetal death increases up to 4 times. Penetration of the virus to the fetus, including its organs, is performed transplacentally during the acute phase of the mother's disease. A positive test result for rubella before pregnancy may indicate good immunity to the disease as a result of its transfer to childhood (according to statistics, about 90% of children suffer rubella asymptomatically) or vaccinated during this period.
- Cytomegalovirus (CMV) is the causative agent of intrauterine cytomegalovirus infection, which can cause pathologies of the internal organs and brain of the fetus. The risk of developing an IVF and the nature of the affected fetus depends on the presence of antibodies in the mother and the duration of infection of the fetus. At primary infection of the mother, the probability of infection of the fetus is 30%. Therefore, women who do not have antibodies to CMV, are recommended monthly monitoring of antibodies to CMV and infection activity indicators, especially during pregnancy in the autumn-winter period. CMV can be found in all body fluids, in connection with this, it can be infected by airborne and sexual means, by passage through the birth canal and even with breastfeeding. That is why the highest probability of infection falls on the first year of the child's life. A person can be a carrier of CMV without the manifestation of specific symptoms of the disease (the clinical picture is similar to banal ARD), but at the same time be a source of infection, in most cases with a decrease in overall immunity.
- Intrauterine herpetic infection is caused by the herpes simplex virus, which is widespread as well as CMV. Herpes of the first type occurs in almost 100% of adults, while in 95% of cases, it causes colds. Infection of the fetus can occur by infection from the cervix or through the blood, which affects the placenta, the fetus, is fraught with the formation of congenital malformations. Possible death of the fetus at any time of development, when passing through the birth canal receive an infection of about 1% of the fruit. The risk of infection of a newborn in genital herpes (herpes of the second type) in the acute phase or in the event of an exacerbation of its chronic condition is 40%. Primary infection in early pregnancy can lead to the need for abortion, at a later date, with constant monitoring of fetal development and its condition, ultrasound-based methods may be therapeutic treatment with antiviral (acyclovir) and immunomodulating drugs. In case of defeat of the genital herpes, caesarean section is recommended. Herpetic infection in newborns can be manifested by local lesions of the skin or eyes (ophthalmoherpes).
Diagnostics of VUI
Given the latency (latency) of the symptoms of the VUI, detection of the presence of intrauterine infections is difficult, but still possible with the help of the following diagnostic techniques.
DNA research using the PCR method (polymer-chain reaction) - used in the detection of infections of sexually transmitted diseases (STDs). The basis of the study is scraping from the genitals. The result is information about the carrier or the presence of an infectious disease. To clarify the diagnosis, depending on the specific type of pathogen, additional studies can be made in the form of bacteriological culture and blood analysis. Analysis of blood for intrauterine infection by ELISA (enzyme immunoassay)