What kind of infection can a newborn have. The result of intrauterine infection on the child. Prevention of intrauterine infections

08.07.2019

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This Privacy Policy governs the processing and use of personal and other data by the Vitaferon employee (website: ) responsible for Users' Personal Data, hereinafter referred to as the Operator.

By transferring personal and other data to the Operator through the Site, the User confirms his consent to the use of the specified data on the terms set forth in this Privacy Policy.

If the User does not agree with the terms of this Privacy Policy, he is obliged to stop using the Site.

The unconditional acceptance of this Privacy Policy is the beginning of the use of the Site by the User.

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7.1. This Privacy Policy and relations between the User and the Operator arising in connection with the application of the Privacy Policy are subject to the law of the Russian Federation.

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8. CONTACT INFORMATION OF THE OPERATOR.

8.1. Contact email.

There are 3 main ways of infection of the placenta, membranes and fetus. One of them, most likely if the mother has chronic sources of infection, is descending or transdecidual, from septic foci under the decidua. Penetrating through the fetal membranes into the amniotic fluid, microorganisms simultaneously spread between the membranes, reaching the basal plate of the placenta, where leukocyte infiltration occurs in response. In the amniotic fluid, the pathogen also multiplies with the development of reactive amnionitis, resulting in a violation of the enzymatic and adsorption functions of the amniotic membranes, which is manifested by polyhydramnios and the accumulation of unlysed meconium. Infection of the fetus can occur through ingestion and aspiration of contaminated amniotic fluid.

In the ascending pathway, pathogens of vaginal infections predominate, causing significant disturbances in the microcenosis of the vagina. The pathogenesis of the lesion in this case is similar to that of the descending path.

The most dangerous is the third, hematogenous route of infection, which is predominant in the presence of a purulent-inflammatory focus in the mother's body and a recurrent viral infection. In case of violation of the barrier function of the placenta with damage to its fetal part, the pathogen can enter the bloodstream of the fetus. Transplacental infection can cause fetal abnormalities and intrauterine sepsis.

Thus, the route of infection is determined by the type of pathogen: a bacterial infection spreads mainly by ascending; for all true viral infections, the hematogenous route of infection is characteristic, it is also typical for such infectious diseases as listeriosis, toxoplasmosis and syphilis.

The degree of structural and functional disorders in the mother-placenta-fetus system largely depends on the course of the infectious process during pregnancy - an acute process, a remission stage, an exacerbation or carriage. An acute infectious process is especially unfavorable. However, the degree of teratogenic effect of infection on the fetal-placental complex is not always unambiguously predictable: even an asymptomatic infection in the mother can have a fatal effect, and a specific acute infection can pass without a trace.

The concept of "intrauterine infection" is conditional, it complements the clinical diagnosis with the prospective birth of a child with the consequences of infectious exposure or an acute inflammatory disease. It is this that should in a certain way influence the obstetric tactics of pregnancy and delivery.

It is not possible to reliably establish the prevalence of the infectious process in IUI without a special study of the fetal material. Therefore, the terms “placentitis, chorionitis, amnionitis, intrauterine fetal pneumonia” appearing in clinical diagnoses and conclusions of EI are not diagnostically reliable.

Identification of acute infectious processes with typical clinical manifestations in pregnant women does not cause serious problems. However, the specificity of IUI currently consists in a chronic persistent course of diseases with atypical manifestations and manifestation of associated pathogens in the third trimester of pregnancy. As a result, even the preventive measures taken during the pre-gravid preparation of the patient or in the first half of pregnancy do not always achieve the desired goal.

When managing pregnant women at high risk of IUI, it is important to observe the stages of examination and the implementation of therapeutic and preventive measures. An algorithmic approach to solving this problem makes it possible to minimize the likelihood of a child being born with an acute infectious process and to avoid the unreasonable use of immunostimulating and antibacterial drugs that increase the level of allergization in newborns.

Stages of examination of pregnant women with a high risk of intrauterine infection

It is advisable to carry out an initial laboratory examination for carriage of BVI in the presence of an increased risk of IUI based on the results of anamnestic testing (prenatal counseling) in the first trimester of pregnancy using the following methods:

blood ELISA for IgM and IgG antibodies;
polymerase chain reaction (PCR) scraping of the mucous membrane of the cervical canal, the surface of the cervix and the walls of the vagina;
bacterial culture of the separated cervical canal and vagina;
bacterial culture of urine;
virusuria.

Search for prognostic echographic markers of IUI:

premature maturation of the placenta (according to the classification of P. Grannum);
contrasting of the basal plate of the placenta (up to 24 weeks);
hyperechoic inclusions (foci) in the placenta;
expansion of gaps and MVP;
thickening of the placenta that does not correspond to the gestational age, with a normal area (size);
bilateral pyelectasis in the fetus with a contrasting pattern of the pelvicalyceal system;
increased hydrophilicity (or reduced echogenicity) of fetal brain tissues;
hyperechoic inclusions in the structures of the fetal brain;
vascular plexus cysts of the fetal brain;
hyperechoic focus in the fetal heart;
hyperechoic intestine.

To state in the conclusion of the EI the presence of echographic signs of IUI, it is sufficient to identify three markers relating to the fetus, placenta and amniotic fluid.

In conclusion, the use of the term "placentitis" and the diagnosis of "intrauterine infection", implying certain clinical signs of the infectious process and morphological changes in the placenta, are categorically unreasonable.

Based on the EI data, conclusions should be drawn about the identification of echographic signs of the influence of an infectious agent, which gives grounds for:

extended laboratory examination of a pregnant woman in the absence of early ascertainment of the fact of carrying the infection;
conducting immunostimulating and specific antibiotic therapy in a pregnant woman with established carriage.

Rubella, prenatal management

The impact of the rubella virus on the fetus

Infection of the mother, both with obvious clinical symptoms and asymptomatic, can lead to infection of the fetus. When a woman becomes ill with rubella in the first trimester of pregnancy, the fetus may be infected with the rubella virus or have an implicit infection without clinical consequences; he may have single organ involvement (usually hearing loss) or multiple organ involvement.

Variants of fetal developmental disorders

Most frequent

Developmental delay (prenatal malnutrition).
Deafness.
Cataract, retinopathy.
Non-occlusion of the arterial duct.
Hypoplasia of the pulmonary artery (or valve stenosis).
Hepatosplenomegaly.

Less frequent

thrombocytopenic purpura.
Delayed psychomotor development.
Meningoencephalitis.
Osteoporosis of tubular bones.
Coarctation of the aorta.
myocardial necrosis.

Microcephaly.
Brain calcification.
Septal defects of the heart.
Glaucoma.
Hepatitis.

Late manifestations (after 3-12 months of life)

Interstitial pneumonia.
Chronic rash resembling rubella.
Repeated infections.
Hypogammaglobulinemia.
Chronic diarrhea.
Diabetes.

Frequency of malformations by trimester

Only primary infection poses an increased risk to the fetus. Rubella disease in the first weeks of pregnancy is accompanied by twice the frequency of spontaneous abortions. The highest risk of congenital rubella is noted in 4-8 weeks of pregnancy (according to prospective studies, 50-60%), in the rest of the first trimester of pregnancy it is 25-30%. In all cases, congenital rubella disease after 9 weeks of gestation is accompanied by hearing loss, retinopathy, and psychomotor retardation. Deafness and retinopathy often occur with rubella disease before the 120th day (up to 17-18 weeks). Cataracts and heart disease are almost always associated with disease that developed before the 60th day of development (up to 9 weeks). Some risk may be associated with the occurrence of this infection even before conception or after 20 weeks of pregnancy.

Pathogenesis

When infected with rubella, the virus begins to multiply in the mucous membrane of the upper respiratory tract and in the adjacent lymph nodes. After 7-10 days, it enters the bloodstream and circulates in it until antibodies appear - usually another 7 days. The total incubation period (from time of exposure to onset of symptoms) is 14-21 days (typically 16-18 days).

Diagnostic methods

The virus can be detected in the blood as early as a week before the rash.

The titer of hemagglutinin-inhibiting antibodies begins to rise when symptoms of the disease appear, reaching a maximum level after 1-3 weeks, after which their level remains almost unchanged for several years. Complement-fixing antibodies increase more slowly (the maximum level is noted approximately 1-2 weeks after the peak of hemagglutinin-inhibiting antibodies), and disappear after a few years.

Rubella-specific IgM antibodies are detected shortly after the rash, peak by day 30, and cease to be detectable by day 80. IgG antibodies increase in parallel with IgM antibodies, but remain at a high level indefinitely. The titer of rubella-specific IgM antibodies increases rapidly after a recent infection and is not detected 4-5 weeks after the onset of the disease; in these terms only IgG as residual antibodies are defined. A positive IgM specific for rubella is the most accurate indicator of a recent infection. A negative IgM result is of little diagnostic value unless it is supported by other laboratory tests.

Obstetric tactics

Many contacts with rubella are actually contacts with patients who have a nonspecific skin rash due to a viral disease. Therefore, it is necessary to verify contact with rubella by serological examination of the alleged patient. To resolve the issue of the possibility of infection with rubella pregnant, a serological diagnosis of the disease is carried out.

When establishing the diagnosis of rubella in a pregnant woman before 20 weeks, it is most advisable to terminate the pregnancy due to the high risk of developmental anomalies in the fetus that are not available for prenatal diagnosis.

Prenatal tactics

Determination of IgM and IgG in the blood of the fetus to diagnose acute rubella infection (fetal T-lymphocytes are able to recognize and inactivate Ig-mother from 16-17 weeks of gestation). Disadvantage of the method: low production of immunoglobulins in the fetus.

Isolation of the virus from the blood of the fetus on culture media. Disadvantage of the method: low cultivation efficiency.

Sonographic signs of probable intrauterine infection

The issue of determining IUI is one of the most difficult in the field of prenatal diagnosis. Any deviation of echographic indicators accompanying the infectious history of a pregnant woman is only one of the manifestations of disorders in the fetal-placental complex. And each of the signs can only be conditionally interpreted as a consequence of the inflammatory process.

When considering the problem of IUI, it is necessary to correctly interpret this concept as a diagnostic position (diagnosis) both in prenatal diagnosis and in obstetric practice. The diagnosis of IUI can serve as a reason for a number of therapeutic measures, including antibiotic therapy.

However, the accepted abbreviation VUI should not be unambiguously interpreted as infection of the fetus - the effect of an infectious agent may be limited to the fetal membranes and placenta, especially since it is difficult to interpret the signs of the infectious state of the fetus itself.

In this regard, the conclusion of the EI signs of IUI should be treated as giving grounds for a special examination of the pregnant woman and preventive therapeutic measures.

It is advisable to replace the IUI with the influence of the infectious factor (HIF), as in the proposed edition.

The VIF echographic marker is never the only, isolated one. By analogy with the syndrome of congenital diseases, there should be at least two echographic signs of VIF. At the same time, in order to establish a clinical diagnosis of “influence of an infectious factor”, three correlating conditions must be observed:

echographic signs of probable VIF are combined with the corresponding clinical picture of the course of pregnancy;
in the distant or immediate history there is confirmation of the likelihood of infection;
in terms of pregnancy more than 26 weeks, when assessing the SP PC, signs of placental dysfunction or insufficiency are revealed.

Extraembryonic formations are subject to predominant and most pronounced changes during HIF.

The earliest signs of infectious exposure in the first trimester of pregnancy are increased echogenicity and dispersion of exocelomic contents, as well as thickening of the walls of the yolk sac.

A subsequent manifestation may be excessive thickening of the chorion with the presence of anechoic small cystic inclusions.

A rare finding is a hyperechoic focus on the amniotic sac. When this echographic phenomenon is detected, it is necessary to differentiate it from the area of the former attachment of the yolk sac of the umbilical cord. Accompanying signs of a possible impact of BVI in this case may be nonspecific changes in the chorion, increased echogenicity of exocelomic contents, as well as an increase in myometrial tone as a sign of a threatened miscarriage.

The most common variant of blastopathies in IUI, which manifests itself at the beginning of the second trimester of pregnancy, is hypoplasia of the amniotic cavity with the presence of excess exocelomic space.

From the second trimester of pregnancy, the echographic manifestations of VIF become more pronounced and distinct.

An increase in the thickness of the placenta, the expansion of the MEP, between which zones of increased echogenicity are determined, is associated with edema of the terminal villi and slowing of blood flow in the lacunae.

Hemangiomas in the region of the marginal sinuses may look like multi-chamber formations and amniotic bands. At the same time, amniotic cords can create a picture of multi-chamber cavity liquid formations subject to the placenta.

This is due to the extremely low speed and non-directional movement of blood elements.

The slowing of blood flow in the lacunae leads to the formation of hemangiomas of various sizes.

Differential diagnosis can be difficult and depends on the skill of the physician. But in both cases, the origin of these formations can be associated with VIF, and their presence can be interpreted as markers of the transferred inflammatory process.

In an acute infectious process, the echographic picture may resemble placental cysts.

This is due to vasodilation, hemorrhages, heart attacks and degenerative changes.

It should be noted that placental cysts can have a diverse appearance - more distinct contours and reduced echogenicity of the internal structure. Cysts with similar echographic characteristics may occur due to the influence of non-infectious factors.

A sign of the completion of the inflammatory process is the appearance in the thickness of the placental tissue of diffusely scattered hyperechoic foci - calcifications or calcified foci of infarcts 3-5 mm in size.

From the point of view of pathomorphology, it is categorically wrong to identify these echographic findings with fatty inclusions in the placenta, which often appears in the conclusions of echographic studies of first-level screening specialists.

The consequence of the inflammatory state of the placenta is always the accumulation and deposition of fibrin in the lacunae and the urinary tract, causing a picture of premature maturation of the placenta.

Coarsely dispersed echopositive suspension in the amniotic fluid - meconium, particles of compacted cheese-like lubricant occur when the production of a proteolytic enzyme and the adsorption function of the amniotic membranes are impaired.

Disability from birth is primarily associated with the transmission of the virus from mother to child during pregnancy. Also, the same reason leads to miscarriage or death of children in the first days of their life. Intrauterine infection in newborns has significant consequences, since the disease can change the process of fetal development. Recently, even a healthy woman who does not have bad habits and chronic diseases has an unhealthy child. This phenomenon is due to the fact that during pregnancy a serious restructuring of the body occurs, and this significantly weakens the woman's immunity, as a result of which viruses that are in the inactive phase begin to develop in the body. This process is especially dangerous in the 1st trimester, at the time of the birth of the fetus. Consider all the features of how intrauterine infection manifests itself in newborns and all the features of such a development of the body.

The problem under consideration has been studied over the past few decades. This is due to the fact that the problem is very common in recent times. The important points of the IUI include the following points:

If the mother's body has a latent infection, then in 10% of cases it is transmitted to the fetus.
In 0.5% of children born have one or another manifestation of symptoms.
Despite the commonly held belief that the infection necessarily passes from mother to child, this is not the case. Some types of infections are not passed from mother to child.
Many infections practically do not manifest themselves in the mother's body. However, the fetus or the newborn child may experience more serious disorders. In a newborn child, symptoms appear almost from the first days of birth.
In order to exclude the possibility of a problem, a timely examination should be carried out. In other words, when planning a pregnancy, you should undergo a complete examination. If the pregnancy was unplanned, then an examination should be carried out at the initial stage.
Modern treatment can reduce the likelihood of transmission of the virus from mother to fetus by almost 100%.

Doctors conduct examinations of pregnant women in order to exclude the possibility of fetal developmental disorders. However, it should be borne in mind that it is the intrauterine infection that the consequences that occur after birth cause the most striking symptoms.

How does infection occur in the fetus?

There are several ways of transmitting the infection. These include:

The above issues should be considered when considering how diseases can be transmitted from mother to child.

pathogens

Almost all viruses can be passed from mother to child. However, only some do not have a strong effect on the fetus. However, there is a group that has a strong impact, that is, the changes become irreversible, causing serious deviations. However, the viruses that cause SARS are not transmitted from mother to child. The only problem that SARS leads to is a serious increase in body temperature, which can harm the fetus. That is why when conducting a check when planning a pregnancy, all infections should be considered. Even harmless infections in children can cause severe symptoms.

What consequences?

Intrauterine infections in a child can develop as follows:

with acute symptoms.
The appearance of chronic symptoms.

It all depends on which infections are transmitted. The acute form is characterized by a state of shock, severe sepsis, pneumonia. Such problems appear almost immediately, the child begins to eat poorly, sleep, activity decreases. However, the infection that takes place inside the mother's body may not appear for a long time.

The chronic manifestation of the problem, when infection has passed during pregnancy, is quite common. Health problems arise in the first years of life, in the future the child will suffer from a phased manifestation of symptoms.

How does the symptom manifest itself?

In the case of transmission of infection from mother to fetus, not only deviations can occur. There are miscarriages, antenatal fetal death, stillbirth, and pregnancy fading occurs, that is, the fetus stops developing. If the infection was passed to the fetus during pregnancy, the following symptoms may occur:

Symptoms appear at the onset of the active phase. However, they can manifest themselves in both the mother and the child.

Whether influences on what term has passed or has taken place an infection?

Intrauterine infection in children causes quite a few health problems. It should be taken into account that the infection of the fetus is dangerous at any stage of pregnancy. In doing so, we note the following points:

In the first trimester, some viruses pose a great health hazard. An example is the rubella virus.
Some pathogens are more dangerous when infected in the last days before childbirth. An example is chicken pox.
Early infection in most cases causes miscarriage, to severe physiological abnormalities of the fetus.
Late infection can be characterized by the fact that the newborn will show symptoms that significantly impair the quality of life.

In order to identify the degree of risk and determine how the symptoms will manifest in the future, they often conduct an ultrasound study, and also take a blood test. Only after determining the type of infection can the correct treatment be prescribed.

Risk group

As a rule, preventing the onset is easier than treating the symptoms that appear. We note the following risk group:

Health care workers encounter infections throughout their work. That is why it should be borne in mind that women should undergo periodic examinations to identify problems.
Women who have a school-age child are also at risk. Schools are a public place where children can become infected and become a carrier.
Employees of kindergartens, schools and public institutions also become carriers of diseases.
Pregnant women who have chronic inflammatory diseases are also at risk.
Women who have given birth before and have passed the pathogen to their child are also at risk.
In the event that the death of the fetus has previously occurred, as well as the development of a defect.
Outflow of amniotic fluid earlier than the established date.

The above points should be considered in order to exclude the possibility of infection of the body before pregnancy.

What are the signs of maternal infection?

There are quite a few signs that a woman has an infection that is in an active or inactive phase. These include the following:

A significant increase in body temperature. It should be borne in mind that pregnancy does not cause an increase in body temperature. Fever is a sign that the immune system is fighting an infection. Therefore, one should take into account the moment that a significant increase in body temperature is the main sign of the onset of the disease.
An increase in lymph nodes in size also indicates a problem.
Severe shortness of breath, coughing, chest pain and many other points indicate that there is a virus in the body.
Conjunctivitis, lacrimation, runny nose - another sign that a woman has significant health problems.
Swelling of the joints indicates that inflammatory processes are taking place in the body.

As a rule, the above signs indicate the presence of allergies, non-communicable diseases, and dangerous infections. Any changes should cause a visit to the doctor. Intrauterine infection during pregnancy is observed by doctors for a long period.

CMV

When considering what can change the course of pregnancy, the possibility of CMV virus in the body of a pregnant woman should be taken into account. What is CMV? This pathogen belongs to the group of herpes viruses, usually transmitted sexually or through the blood. In some cases, it is likely that the transmission of the pathogen will pass through household contact. This virus cannot be transmitted antenatally.

According to studies, almost half of the women in Europe are faced with the virus in question once in their lives. Even if the virus is not in the active phase, it can significantly harm the fetus. CMV in most cases affects the fetus in the third semester, but with infection in the first semester, the consequences are more severe. According to studies, the risk of infection in a child is 30-40%, and in 90% the symptoms do not manifest themselves. Quite a lot of attention is paid to intrauterine infection of the fetus due to the fact that 10% of newborns have a lot of symptoms.

Despite the low percentage of infection and the manifestation of symptoms, the signs of the manifestation of the problem can be called the following list:

A miscarriage occurs when the fetus is infected in the first trimester.
Low birth weight or dystrophy.
Significant hearing loss or congenital deafness.
Brain development disorder.
Accumulation of fluid in the brain.
development of pneumonia.
Damage to the liver and spleen.
Blindness in varying degrees of manifestation.
Delay in the development of the child.

If a combination of symptoms occurs, then the child dies in the first months of life. Many people develop individual deviations: deafness, blindness, mental retardation. But the symptoms are not always expressed by health problems, since the virus may not be transmitted. There are practically no effective means of removing the virus from the body of a newborn. There are drugs that can significantly alleviate the symptoms of eye damage or pneumonia. Many doctors argue that the development of CMV is not a reason for terminating a pregnancy, since with proper treatment, there is a high probability of having an absolutely healthy baby.

HSV

The most common is the herpes simplex virus. When it is transmitted sexually, there is a possibility that the baby has a herpes infection. It is worth considering the moment that in the first 28 days after birth, symptoms of the disease in question may appear. Often, the infection passes at the time of passage of the child through the birth canal.

The consequences for the child with an untimely appointment of treatment, if the mother has a herpes virus, are as follows:

Miscarriage.
Appetite worsens significantly, fever occurs.
Pneumonia.
Eye damage.
The appearance of a characteristic rash on the body.
Some degree of brain damage.

The most difficult situation can be called the case when, on the 4-7th day of life after birth, all symptoms begin to appear. When the damage to the child's organs passes, there is a chance that he will die from shock. The virus often infects the brain, which leads to significant changes. That is why congenital disability occurs quite often in children due to the congenital hepatitis virus. However, it should be borne in mind that the virus is quite dangerous, but often not transmitted to the child at birth. The simplest form of manifestation is the appearance of skin diseases and eye damage.

Often, treatment takes place in the 3rd trimester with special antiviral drugs. That is why it is imperative to consult a doctor. Herpes can be manifested by the appearance of a certain rash on the genitals, and during pregnancy, the disease is transmitted. With a bright manifestation of symptoms, doctors may prescribe a caesarean section.

In conclusion, we note that when planning a pregnancy, you should undergo a thorough examination to identify hidden chronic diseases and viral infections. Only after treatment can pregnancy be planned, otherwise the child may develop very serious problems leading to disability. If the problem was identified already at the time of pregnancy, then a certain course of treatment is prescribed, which will eliminate the possibility of transmitting the virus from mother to child. However, there is a chance that the doctor will recommend terminating the pregnancy due to the development of a serious virus in the mother's body. Do not forget that some infections during pregnancy are very, very dangerous.

Developing in the mother's belly, the child is relatively safe. In relative terms, since even in such sterile conditions there is a risk of developing an infectious disease. This large group of diseases is called intrauterine infections. During pregnancy, a woman should especially carefully monitor her health. A sick mother can infect her child during fetal development or during childbirth. The signs and methods of diagnosing such diseases will be discussed in the article.

The danger of intrauterine infections is that they unceremoniously interfere in the formation of a new life, which is why babies are born weak and sick - with defects in mental and physical development. Such infections can cause the greatest harm to the fetus in the first 3 months of its existence.

Intrauterine infection during pregnancy: what the statistics say

A timely diagnosed and treated infectious disease in a pregnant woman poses a minimal danger to her child.
Infectious agents pass from mother to baby in 10 out of 100 pregnancies.
0.5% of babies infected in the womb are born with the corresponding signs of the disease.
An infection that has settled in the mother's body does not necessarily pass to the fetus, and the child has a chance to be born healthy.
A number of infectious diseases that do not bode well for the baby may be present in the mother in a latent form and practically do not affect her well-being.
If a pregnant woman falls ill with one or another infectious disease for the first time, it is likely that the child will also become infected from it.

Intrauterine infection - ways of infection of the embryo

There are four ways that infectious agents can enter a tiny growing organism:

hematogenous (transplacental) - from the mother, harmful microorganisms penetrate to the fetus through the placenta. This route of infection is characteristic of viruses and toxoplasma;
ascending - infection occurs when the pathogen rises to the uterus through the genital tract and, having penetrated into its cavity, infects the embryo. So the baby may have a chlamydial infection and enterococci;
descending - the focus of infection is the fallopian tubes (with adnexitis or oophoritis). From there, the pathogens enter the uterine cavity, where they infect the child;
contact - infection of the baby occurs during childbirth, when it moves along the birth canal of a sick mother. Pathogens enter the body of the child after he swallowed infected amniotic fluid.

Intrauterine infection at different stages of pregnancy: consequences for the child

The outcome of infectious infection of the fetus depends on at what stage of intrauterine development it was attacked by dangerous microorganisms:

gestational age 3 - 12 weeks: spontaneous abortion or the appearance of various developmental anomalies in the fetus;
gestational age 11 - 28 weeks: the fetus noticeably lags behind in fetal development, the child is born with insufficient body weight and various malformations (for example, congenital heart disease);
gestational age after 30 weeks: developmental anomalies affect the organs of the fetus, which by this time have already formed. The infection poses the greatest danger to the central nervous system, heart, liver, lungs and organs of vision.

In addition, congenital infection has an acute and chronic form. The following consequences indicate an acute infection of a child at birth:

shock state;
pneumonia;
sepsis (blood poisoning).

Some time after childbirth, an acute intrauterine infection in newborns can manifest itself with the following signs:

excessive daily sleep duration;
poor appetite;
insufficient physical activity, which decreases every day.

If congenital infection is chronic, the clinical picture may be absent altogether. Distant signs of intrauterine infection are:

complete or partial deafness;
deviations in mental health;
vision pathology;
lagging behind peers in motor development.

The penetration of infection to the fetus through the uterus leads to the following consequences:

the birth of a dead baby;
intrauterine death of the embryo;
frozen pregnancy;
spontaneous abortion.

In children who survived such infection, the following pathological consequences are recorded:

heat;
rash and erosive skin lesions;
non-immune dropsy of the fetus;
anemia;
enlarged liver on the background of jaundice;
pneumonia;
pathology of the heart muscle;
pathology of the eye lens;
microcephaly and hydrocephalus.

Intrauterine infection: who is at risk

Every expectant mother is at risk of being captured by an infectious agent, because during pregnancy the defenses of her body are exhausted to the limit. But the greatest danger lies in wait for women who:

already have one or more children attending kindergarten, school;
are related to the field of medicine and are in direct contact with people who may be potential carriers of the infection;
work in a kindergarten, school and other children's institutions;
have had 2 or more medical abortions in the past;
have inflammatory diseases in a sluggish form;
faced with an untimely rupture of amniotic fluid;
have had a pregnancy in the past with abnormal development of the embryo or intrauterine fetal death;
have already given birth to a baby with signs of infection in the past.

Symptoms of intrauterine infection in a woman during pregnancy

Doctors distinguish several universal signs by which it can be assumed that the expectant mother has contracted an infectious disease:

a sharp increase in temperature, fever;
shortness of breath when walking or climbing stairs;
cough;
rash on the body;
enlarged lymph nodes, painfully responsive to touch;
sore joints that look swollen
conjunctivitis, lacrimation;
nasal congestion;
pain in the chest.

Such a set of indications may also indicate the development of an allergy in a pregnant woman. In this case, there is no threat of infection of the fetus. Be that as it may, the expectant mother should go to the hospital as soon as at least one of these symptoms appears.

Causes of intrauterine infection during pregnancy

The activity of ubiquitous pathogenic microorganisms is the main cause of morbidity among women who are preparing to become mothers. Many bacteria and viruses, getting into the mother's body, are transmitted to the child, provoking the development of serious anomalies. Viruses responsible for the development of acute respiratory viral diseases do not pose a danger to the fetus. A threat to the condition of the child appears if only a pregnant woman has a high body temperature.

One way or another, but intrauterine infection of the baby occurs exclusively from a sick mother. There are several main factors that can contribute to the development of infectious pathology in the fetus:

Acute and chronic diseases of the mother in the genitourinary system. Among them are such inflammatory pathologies as cervical ectopia, urethritis, cystitis, pyelonephritis.
The mother is immunocompromised or HIV-infected.
Transplantation of organs and tissues that a woman has undergone in the past.

Intrauterine infections: main characteristics and ways of infection

Cytomegalovirus (CMV)

The causative agent of the disease is a representative of herpes viruses. You can get the disease through sexual and close household contact, through blood (for example, when transfused from an infected donor).

With the primary infection of a woman in position, the microorganism penetrates the placenta and infects the fetus. In some cases, no abnormal consequences after infection in the baby are observed. But at the same time, statistics say: 10 babies out of 100, whose mothers encountered an infection during pregnancy, have pronounced signs of intrauterine infection.

The consequences of such an intrauterine infection during pregnancy are as follows:

spontaneous abortion;
the birth of a dead baby;
hearing loss of neurosensory origin;
low birth weight;
hydro- and microcephaly;
pneumonia;
lag in the development of psychomotor;
pathological enlargement of the liver and spleen;
blindness of varying severity.

Cytomegalovirus under a microscope

If the infectious lesion is of a general combined nature, more than half of the children die within 2 to 3 months after birth. In addition, the development of such consequences as mental retardation, hearing loss and blindness is likely. With a slight local lesion, the consequences are not so fatal.

Unfortunately, there are no drugs yet that can eliminate the symptoms of CMV in newborns. If a woman in a position has been diagnosed with cytomegalovirus infection, the pregnancy is left, because the child has a chance to stay healthy. The expectant mother will be prescribed an appropriate course of treatment in order to smooth out the effect of the disease on her body as much as possible.

Intrauterine infection - herpes simplex virus (HSV)

A newborn baby is diagnosed with a congenital herpes infection if his mother has herpes simplex virus type 2, which in most cases is infected through unprotected sexual contact. Signs of the disease will appear in the child almost immediately, during the first month of life. Infection of the baby occurs mainly during childbirth, when it moves through the birth canal of an infected mother. In some cases, the virus enters the fetus through the placenta.

When a child's body is affected by a herpes infection, the consequences are severe:

pneumonia;
violation of visual function;
brain damage;
skin rash;
heat;
poor blood clotting;
jaundice;
apathy, lack of appetite;
stillbirth.

Severe cases of infection result in oligophrenia, cerebral palsy and a vegetative state.

Herpes simplex virus under the microscope

Intrauterine infection - rubella

This disease is rightfully considered one of the most dangerous for the life of the embryo. The route of transmission of the rubella virus is airborne, and infection is possible even at a great distance. The disease, which poses a particularly great threat before the 16th week of pregnancy, “programs” various deformities in the development of the baby:

low birth weight;
spontaneous abortion, intrauterine death;
microcephaly;
congenital anomalies in the development of the heart muscle;
hearing loss;
cataract;
various skin diseases;
pneumonia;
unnatural enlargement of the liver and spleen;
meningitis, encephalitis.

Intrauterine infection - parvovirus B19

The presence of this virus in the body provokes the development of a disease known as infectious erythema. In adults, the disease does not manifest itself in any way, since it proceeds latently. However, the consequences of the pathology for the fetus are more than serious: the child may die before birth, and there is also a threat of spontaneous abortion and intrauterine infection. On average, infected children die in 10 cases out of 100. At 13-28 weeks of gestation, the fetus is especially defenseless against this infection.

When infected with parvovirus B19, the following consequences are noted:

puffiness;
anemia;
brain damage;
hepatitis;
inflammation of the myocardium;
peritonitis.

Intrauterine infection - chickenpox

When a future mother is infected with chickenpox, the infection also affects the child in 25 cases out of 100, but there are not always symptoms of the disease.

Congenital chickenpox is identified by the following features:

brain damage;
pneumonia;
skin rash;
delayed development of the eyes and limbs;
optic atrophy.

Newborn babies infected in the womb are not treated for chickenpox, since the clinical picture of the disease does not progress. If the pregnant woman "caught" the infection 5 days before the birth and later, the child will be given an injection of immunoglobulin after birth, since there are no maternal antibodies in his body.

Intrauterine infection - hepatitis B

You can get a dangerous virus during sexual intercourse with an infected person in the absence of barrier methods of contraception. The causative agent of the disease enters the baby through the placenta. The most dangerous period in terms of infection is from 4 to 9 months of pregnancy. The consequences of infection for a child are:

hepatitis B, which is treatable with the appropriate approach;
oncological diseases of the liver;
sluggish form of hepatitis B;
an acute form of hepatitis B, which provokes the development of liver failure in a child and he dies;
delay in the development of psychomotor functions;
hypoxia;
miscarriage.

Intrauterine infection - human immunodeficiency virus (HIV)

HIV infection is a scourge for specific immune lymphocytes. In most cases, infection occurs during sexual intercourse with a sick partner. A child can become infected while in the womb, or already during childbirth. HIV-infected children are shown intensive complex treatment, otherwise they will not live even two years - the infection quickly "eats" a weak organism. Infected children die from infections that do not pose a mortal danger to healthy babies.

To confirm HIV in an infant, a polymerase chain reaction diagnostic method is used. It is also very important to timely detect the infection in the body of a pregnant woman. If the baby is lucky enough to be born healthy, the mother will not breastfeed him so that the infection is not transmitted to him through milk.

Intrauterine infection - listeriosis

The disease develops as a result of the vital activity of the Listeria bacterium. The microorganism easily penetrates to the fetus through the placenta. Infection of a pregnant woman occurs through unwashed vegetables and a number of food products (milk, eggs, meat). In a woman, the disease may be asymptomatic, although in some cases fever, vomiting and diarrhea are noted. In an infected baby, the signs of listeriosis are as follows:

rash and multiple accumulations of pustules on the skin;
brain inflammation;
refusal of food;
sepsis;
spontaneous miscarriage;
the birth of a dead baby.

If signs of listeriosis become apparent in the first week after birth, then babies die in 60 cases out of 100. After listeriosis is confirmed in a pregnant woman, she is prescribed a two-week course of treatment with Ampicillin.

Intrauterine infection - syphilis

If a woman in position has syphilis, which she has not treated, the probability of infecting her child is almost 100%. Out of 10 infected babies, only 4 survive, and the survivors are diagnosed with congenital syphilis. The child will become infected even if the disease is latent in the mother. The results of the activity of the infection in the child's body are as follows:

tooth decay, damage to the organs of vision and hearing;
damage to the upper and lower extremities;
the formation of cracks and rashes on the skin;
anemia;
jaundice;
lag in mental development;
premature birth;
stillbirth.

Intrauterine infection - toxoplasmosis

The main carriers of toxoplasmosis are cats and dogs. The causative agent of the disease enters the body of the expectant mother when she takes care of her pet or, out of habit, tastes meat with an insufficient degree of heat treatment while preparing dinner. Infection during pregnancy poses a great danger to the intrauterine development of the crumbs - in 50 cases out of 100, the infection overcomes the placental barrier and affects the fetus. The consequences of infection of the child are as follows:

damage to the organs of vision;
hydrocephalus;
microcephaly;
abnormally enlarged liver and spleen;
brain inflammation;
spontaneous abortion;
delay in the development of psychomotor functions.

Cytomegalovirus, rubella, toxoplasmosis, herpes, tuberculosis, syphilis and some other diseases are combined into a group of so-called TORCH infections. When planning a pregnancy, future parents take tests that help identify these pathological conditions.

Tests for intrauterine infections during pregnancy

Within 9 months, the expectant mother will have to undergo more than one laboratory test so that the doctors make sure that she is healthy. Women in position take a blood test for hepatitis B and C, syphilis. For pregnant women, the PRC method is also practiced, thanks to which it is possible to detect active viruses in the blood, if any. In addition, expectant mothers regularly visit the laboratory to take a smear from the vagina for microflora.

Ultrasound is essential for successful pregnancy management. This method is absolutely safe for the fetus. And although this procedure is not directly related to the diagnosis of infectious diseases, doctors can use it to detect abnormalities in fetal development caused by pathogenic microorganisms. There is every reason to talk about intrauterine infection if the following symptoms become apparent on ultrasound:

Formed pathologies of development.
Polyhydramnios or oligohydramnios.
Edema of the placenta.
An enlarged abdomen and unnaturally enlarged structural units of the kidneys.
Enlarged internal organs: heart, liver, spleen.
Foci of calcium deposition in the intestines, liver and brain.
Enlarged ventricles of the brain.

In the diagnostic program for examining expectant mothers belonging to the risk groups that we talked about above, a special place is occupied by the seroimmunological method for determining immunoglobulins. As needed, doctors resort to amniocentesis and cordocentesis. The first method of research is to study amniotic fluid, the second involves the study of cord blood. These diagnostic methods are very informative in detecting infection. If the presence of an intrauterine infection is suspected in an infant, then the biological fluids of the baby, for example, saliva or blood, serve as the material for the study.