Every pregnant woman in the first trimester undergoes a mandatory examination, revealing the possible presence of infectious diseases that adversely affect the further development of the fetus. But, unfortunately, not everyone knows how dangerous pathogens can be for an unborn child.
Over the past ten years, a tendency toward an increase in intrauterine infection, leading to fetal death, has been clearly observed. According to statistics, an average of 45% of all women of childbearing age during the examination revealed a herpes simplex virus and cytomegalovirus. In 55% of women, normal microflora is detected.
What is an intrauterine infection?
Intrauterine infection is a disease transmitted from an infected mother to her baby during pregnancy or childbirth. The main predisposing factor is chronic kidney and pelvic disease.
Intrauterine infection can be dangerous depending on the duration of pregnancy, the characteristics of the immune system, the condition of the fetus and the type of infection. The main danger comes from the initial infection, as the mother’s body is not able to cope with the disease.
The main causative agent causing severe pathology of the fetal development is SARS - a complex that includes: rubella (R), toxoplasmosis (To), herpes (H) and cytomegalovirus (C).
Sexually transmitted diseases (STDs) , which include chlamydia, ureaplasmosis, gonorrhea, microplasmosis and trichomoniasis, do not cause serious fetal damage in comparison with the SARS complex.
In addition, the main danger to the unborn child is HIV, hepatitis (C and B), syphilis.
Causes of fetal infection
The main cause of infection is an infected mother. However, there are other ways of infection:
- During a placenta biopsy (placentocentresis)
- During a puncture when taking amniotic fluid (amniocentres)
- With the introduction of vascular placenta preparations
- Various operational methods for examining the condition of the fetus or placenta
Ways of infection fetus
- Ascending infection. Malicious bacteria rise from the vagina to the uterus, where they enter the amniotic membrane and the water. An infected partner can also spread the infection through sperm.
- The downward path of infection is to get the infection from the abdominal cavity into the uterus. This can be caused by an ovarian abscess or appendicitis.
- Hematogenous pathway. If a large number of bacteria or viruses predominate in the mother’s blood, then the infection occurs through the blood and blood vessels.
Diagnostics
Intrauterine infection is diagnosed both at different stages of pregnancy, and after the birth of a baby. The main method to detect the presence of pathogens is the examination of a pregnant woman. Examination of blood, urine, saliva, and cervix indicates the presence of immunoglobulins (G and M) indicating a relapse or primary infection.
A small titer of immunoglobulin G indicates immunization of the pregnant woman (i.e., a cured or past infection). The increase in G titers or the manifestation of immunoglobulin M indicates re-infection of a pregnant woman.
IgG-gM- - indicates the absence of disease
IgG + gM- - there is immunity to a previous disease
IgG- gM + - primary infection
IgG + gM + - relapse, and immunity during primary infection
After birth, a newborn baby is also tested for blood, meconium, urine and, if necessary, cerebrospinal fluid. Identification of the causative agent of the disease allows to determine the sensitivity to antibiotics, which favorably affects the further treatment of the child.
Effect on the fetus
It is no secret that intrauterine infection can provoke a miscarriage or a frozen pregnancy in the short term. This may be due to severe malformations or increased uterine tone.
In addition, intrauterine infection of the fetus can cause severe damage to tissues and organs: inflammation of the lungs, liver, gastrointestinal tract, skin, brain, etc. It is worth noting that in a newborn child, the disease is more pronounced than in an adult.
It is worth remembering that the mild, asymptomatic course of the disease in the mother can be detrimental to the development of the fetus.
In the early stages (up to 12 weeks), an intrauterine infection, the consequences of which are unpredictable, can provoke fetal death. At later dates, severe pathologies can develop, for example, accumulations of fluid in the brain. If the infection occurred before childbirth, the infection manifests itself in the first week after delivery.
Intrauterine infection causes placental insufficiency: the delivery of oxygen and nutrients is disrupted, the production of hormones responsible for maintaining pregnancy is reduced, and the antimicrobial properties of the placenta are reduced.
What to do?
Early detection of infection can reduce the risk of its spread, maintain pregnancy and give birth to a healthy baby. To prevent intrauterine infection, antibiotic therapy is used, which is carried out in the second trimester. Antibacterial drugs prescribed by a doctor can reduce the risk of developing an infection and prevent its harmful effects on an unborn baby. Also prescribed drugs that improve placental circulation, fetal nutrition and reduce uterine tone.