Signs of fetal infection during pregnancy. Intrauterine infection during pregnancy: types, symptoms, treatment. Intrauterine infections: main characteristics and routes of infection

15.05.2019

The infection enters the amniotic fluid from the vagina;
- the infection enters the amniotic fluid through the fallopian tubes;
- the infection enters the amniotic fluid through the wall of the uterus.

Through the placenta.
Through the blood.

Intrauterine infection most commonly caused by the following microorganisms:

1. Viruses:

Herpes virus (congenital herpes).
(congenital cytomegaly).
Rubella virus (congenital rubella).
Less commonly: enteroviruses, influenza virus, adenovirus.

2. Bacteria:

Listeria (congenital listeriosis).
Tuberculosis bacillus (congenital tuberculosis).
The causative agent of syphilis (congenital syphilis).

3. Chlamydia (congenital rubella). It is recommended to treat chlamydia, and your doctor will tell you how to treat chlamydia.
4. Mycoplasma (congenital mycoplasmosis).
5. Toxoplasma (congenital toxoplasmosis).
6. Mushrooms (congenital candidiasis).

Influence of gestational age on the course of intrauterine infection

Flow intrauterine infection strongly depends on the gestational age at which the fetus became infected. Changes in the fetus that occur at a certain stage of pregnancy will be similar with any infection, be it herpes, or toxoplasma, or another pathogen.

At 1-2 weeks, the formation of a multicellular embryo of the fetus takes place. By the end of the 1st week, the embryo is introduced into the mucous membrane of the uterus (embryo implantation), and this process can be disrupted. Any negative impact during this period, including infection, will provoke intrauterine fetal death and spontaneous death.

From the 3rd to the 12th week, the formation of the main vital organs and systems occurs: the circulatory, respiratory, digestive, nervous, genitourinary systems, etc. gross defects (malformations of the heart, brain, kidneys, intestines, etc.).

From the 13th week before childbirth, the fetus grows rapidly, the fine structures and functions of the body mature.

Therefore, with an adverse effect during this period, the violation will be at the level of the functions of organs and systems. Such an effect will not cause gross deformities. Some minor defects, such as cleft lip ("cleft lip"), may appear if the infection was active at the beginning of this period.

If the infection occurs at the end of pregnancy in the third trimester (from the 22nd week), the fetus will develop a real illness with characteristic symptoms: hepatitis, pneumonia, encephalitis, nephritis, etc. In addition, the size of the fetus will suffer: the baby will be born small and small in stature. A child born in the acute period of an infectious disease is contagious.

Depending on the time of infection, the following disease outcomes are possible:

Intrauterine fetal death and miscarriage (infection occurred in early pregnancy).
Malformations (eg, heart defects, brain defects, and others). The infection occurred at a fairly early stage, and the inflammatory process has already ended.
The birth of a child in the midst of an illness. Infection occurred at a later date, the inflammation continues, the child is contagious.
The birth of a child with malnutrition (low weight) and short stature.

Intrauterine infection symptoms

For intrauterine infection the following signs are characteristic:

Neurological disorders: seizures, hypertensive-hydrocephalic syndrome and others.
Developmental defects.
Prolonged, growing jaundice, lasting several months.
Enlargement of the liver and spleen.
Anemia.
Temperature rises.
Delayed development: physical, mental, motor.
A rash on the skin of a different nature, depending on the pathogen.

Congenital rubella (rubella). Rubella is dangerous only for pregnant women, because in the overwhelming majority of cases it causes fetal deformities (changes in the size of the skull, congenital deafness, cataracts and heart defects). If a woman suffers from rubella in the first three months of pregnancy, this is considered an absolute indication for her termination.

Congenital cytomegaly. Multiple lesions are characteristic: enlargement of the liver and spleen, anemia, prolonged jaundice, blood clotting disorders, pneumonia, brain damage, eyes, low weight.

Congenital herpes. Herpes infection can occur not only in the womb, but also during the passage of the child through the birth canal. The disease occurs in about 50% of infected infants. A common herpes infection is accompanied by significant damage to the brain, liver, adrenal glands. Bubble rashes on the skin are characteristic. The course of the disease is very difficult and in the overwhelming majority of cases ends in coma and death of the child.

Congenital listeriosis. Listeria is a bacteria that a pregnant woman can get from animals. They enter the fetus through the blood. They affect the brain, often cause fetal death. In the clinical picture: meningitis, encephalitis, muscle tone disorders, skin rash and respiratory disorders.

Congenital chlamydia. The development of chlamydial pneumonia and conjunctivitis is characteristic.
If an intrauterine infection is suspected, special blood tests are performed, confirming its presence, determining the pathogen and the period of the course (the acute period or inflammation has already been completed).

Treatment of intrauterine infection

Main directions:

If a child was born in an acute period, drugs that act on the pathogen are prescribed to him.
Basically, the treatment is symptomatic: the treatment of the manifestations of the disease. Hypertensive-hydrocephalic syndrome, convulsive syndrome, pneumonia, hepatitis are treated, surgical operations are performed to eliminate malformations, etc.
Preparations for enhancing immunity.

Forecast intrauterine infection generally disappointing. Usually, the later the infection occurs, the better for the child, there will be no terrible malformations, the disease will not have time to damage the vital organs and the brain.

Prevention of intrauterine infection

It is advisable, before conceiving a child, to be tested for intrauterine infections and treat them if they show up. Women who have not had rubella can be vaccinated. Many infections that affect the fetus are sexually transmitted. Hygiene of sexual relations and fidelity in the family are the key to the prevention of these diseases.

Every mother-to-be has to be tested for many infections - even if he feels completely healthy. A woman is especially anxious if the causative agents of any disease are found. What is the danger of intrauterine infections (IUI) for the fetus and can they be prevented?

Intrauterine infection (IUI) is an infection that develops in the fetus in the womb. The source of intrauterine infection is the body of a pregnant woman. In this case, the child is born already infected or sick. It is also possible that a child is infected directly during childbirth, when passing through an infected birth canal.

During pregnancy, a woman can get any infection, and each of them can have an adverse effect on the fetus. But the ability of different microorganisms to infect the fetus and placenta is different. Most of them can negatively affect the fetus only in the presence of concomitant factors in the form of any diseases, unfavorable living conditions, stressful situations.

The unconditioned pathogens, especially often causing the formation of severe fetal pathology, include infections combined into the so-called TORCH complex: Toxoplasmosis, R-rubella, C-cytomegalovirus and H-herpes.

Chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis, gonorrhea, related to sexually transmitted diseases (STDs), do not cause such severe damage to the fetus as TORCH-complex infection, but given their wide spread among women of childbearing age, the importance of these infections is also great ...

The viruses of hepatitis B and C, HIV and syphilis also pose a significant danger to the fetus. Currently, screening for all these infections is mandatory for all pregnant women.

Diagnosis of intrauterine infections (IUI)

To identify the causative agents of STDs, diagnostics is carried out using the polymerase chain reaction (PCR), which detects the DNA of the pathogens. To do this, they take scrapings from the genitals for research.

The blood is examined for the presence of antibodies to pathogens of the TORCH complex, HIV, syphilis and hepatitis B and C.

The doctor will most likely inform her that the pregnant woman is infected based on the results of the examination, since most of these diseases are asymptomatic.

Identification of the pathogen according to PCR (DNA research) data can mean either carriage or the presence of a disease. Bacteriological cultures and / or blood tests may be used to clarify the diagnosis, depending on the specific infection.

When examining blood tests, protective antibodies of classes M and G can be detected. If only antibodies of class G are detected in the blood, this means that the infection occurred a long time ago, possibly even before pregnancy, the body has formed immunity to this pathogen and at the moment the disease does not pose a danger to the mother and fetus.

The detection of class M antibodies in most cases indicates the acute phase of the disease, even if there are no manifestations. If antibodies to the pathogen are not found, then there is no immunity to this disease in the body. However, in each specific case, options are possible, therefore, the doctor should evaluate the test results.

Impact of intrauterine infections (IUI) on pregnancy

The presence of an infection in a pregnant woman can provoke an abortion at any time. This can occur either due to an increase in the tone of the uterus in response to inflammation in the woman's genitals, or due to intrauterine infection of the fetus.

Intrauterine infection (IUI) can be manifested by damage to various organs and tissues of the fetus: inflammation of the liver (hepatitis), gastrointestinal tract (gastroenteritis), lungs (pneumonia), membranes and brain matter (meningoencephalitis), ear (otitis media), nasal mucosa ( rhinitis), skin (pyoderma), etc. Moreover, the severity of the disease of the fetus and newborn is much more pronounced than in an adult. There is a very high probability of penetration of microorganisms into the bloodstream with the development of damage to the entire body of the child.

The greatest problems arise with co-infection. It is known that a combination of even two infections mutually enhances their negative effect on the body, and also causes a decrease in immunity, which reduces the effectiveness of treatment.

It should also be noted that even with a normal pregnancy, some suppression of immunity occurs, which is necessary for bearing a fetus, therefore, it is during pregnancy that one can observe the activation of latent infectious diseases.

If there is an infectious agent in the body of a pregnant woman, there is most often inflammation of the vagina and cervix - this can be detected by the doctor during examination, but, as already mentioned, the process can be hidden, without any pronounced manifestations.

If the infection is not detected at the stage, in the future it may spread to the mucous membrane of the uterus, the membranes of the fetus and the placenta and, further, infection of the fetus.

In the presence of full-fledged immunity in a pregnant woman, the infection may not affect the condition of the fetus, remaining localized in the cervical canal and vagina. In this case, however, the possibility of infection of the newborn while passing through the birth canal of the mother remains.

It should be noted that a mild, possibly even asymptomatic, infection in the mother can cause the development of severe damage to the placenta and the fetus, up to its death.

The severity of the fetal disease and the outcome of pregnancy directly depend on the period at which the infection occurred. The sooner the infection spreads to the fetus, the more severe its condition. In the early stages of pregnancy (up to 10-12 weeks), infection of the fetus, as a rule. Accompanied by his intrauterine death and early miscarriage.

At a later date, under the influence of infection, it is possible to form pathology of various organs and systems of the fetus, for example, hydrocephalus - the accumulation of fluid in the ventricles of the brain. If the infection occurs before childbirth, then the disease manifests itself in the first days after childbirth.

The main manifestation of fetal suffering during pregnancy is the development of placental insufficiency. At the same time, the processes of delivery of nutrients and oxygen necessary for the growth and development of the fetus, the production of hormones necessary for the development and maintenance of pregnancy, as well as the process of removing toxic substances are disrupted; the antimicrobial action of the placenta also worsens.

To prevent intrauterine infection of the fetus, the disease is treated in a pregnant woman. As a rule, these are antibacterial agents that are prescribed in the second trimester of pregnancy, when the risk of adverse effects of drugs on the fetus is significantly reduced.

Unfortunately, the choice of drugs approved for use in pregnancy is very limited, so the treatment of infections in pregnancy presents certain difficulties.

In addition to treating the underlying disease, placental insufficiency is prevented. a healthy placenta in most cases prevents the spread of the infection to the fetus.

For this purpose, drugs are prescribed that improve blood circulation, reduce the tone of the uterus, metabolic complexes that improve the nutrition of the fetus.

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The main source of infection in IUI is the mother of the child, from whose body the pathogen enters the fetus (vertical transmission mechanism). In this case, infection occurs both ascending, transplacental and transovarial routes, as well as contact and aspiration (directly during childbirth) routes. Moreover, for antenatal infections, the most typical hematogenous, and for intranatal infections, the ascending pathway of infection. It has been proven that today the most common infections that are transmitted from mother to fetus are sexually transmissible bacterial infections, among which genital chlamydia and genital herpes are the most common.

In the pathogenesis of the onset and development of IUI, the gestational age is of particular importance. The fetus does not react to infectious antigens until 12-14 weeks of gestation, since it lacks immunocompetent cells, immunoglobulins and does not show immune reactions. Infectious damage to the embryo at 3 to 12 weeks is usually associated with a viral infection that freely penetrates the chorion. Since during this period (period - organogenesis, placentation), as mentioned above, the fetus does not yet have anti-infective defense systems, IUI leads to the formation of malformations (teratogenic) or death of the embryo (embryotoxic effect).

With the onset of the second trimester of pregnancy, the mechanism of action of the ascending infection changes due to the fusion of the deciduas capsularis with the deciduas parietalis *. At this time, an ascending infection can penetrate the fetus from the vagina or cervical canal. From this period of pregnancy, the internal pharynx of the cervical canal comes into contact with the aqueous membranes of the fetus and, in the presence of infection, microorganisms penetrate the amniotic fluid. The amniotic fluid acquires antimicrobial properties only after the 20th week of pregnancy, when, in response to the action of an infectious agent, an inflammatory proliferative reaction develops, limiting the further penetration of infection, due to the appearance of lysozyme, complement, interferons, immunoglobulins.

* Decidua (decidua) is the lining of the uterus after implantation. The decidua from the 4th month after fertilization and before delivery has three parts: Decidua basalis - that part of the uterine mucosa, which is located under the placenta. Decidua capsularis - Covers the embryo and separates it from the uterine cavity. Decidua parietalis - the rest of the mucous membrane of the uterus, on the sides and opposite the implantation site. As Decidua capsularis and Decidua parietalis grow, they come into contact with each other and connect.

In the third trimester of pregnancy, the antibacterial protection of amniotic fluid increases. During this period, the role of the exudative component prevails in the inflammatory reaction of the fetal tissues, when, in response to the penetration of infection, inflammatory leukocyte reactions develop in the fetus (encephalitis, hepatitis, pneumonia, interstitial nephritis).

Particularly dangerous with IUI in the II and III trimesters of pregnancy is fetal brain damage, which manifests itself in various severe disorders in the formation of the brain: hydrocephalus, subependymal cysts, cystic degeneration of the brain substance, anomalies in the development of the cortex, microcephaly (development of ventriculitis is also possible), which, in in turn, leads to mental retardation, retardation of the psychomotor development of children.

Changes in the state of the fetus and the functioning of the fetoplacental system caused by intrauterine infection of the fetus are reflected in the composition and properties of the amniotic fluid. When an infectious agent enters the amniotic fluid, it multiplies unhindered, followed by the development of chorionitis (placentitis) and chorioamnionitis. The syndrome of "infection of amniotic fluid" develops. The fetus finds itself in an infected environment, which creates favorable conditions for infecting the fetus by contact, i.e. through the skin, mucous membranes, respiratory and gastrointestinal tracts. When swallowing and aspiration of infected waters in a newborn, such signs of intrauterine infection appear as pneumonia, enterocolitis, vesiculosis, omphalitis, conjunctivitis, etc.

With intrauterine infection (against the background of amnionitis), as a rule, polyhydramnios occurs, which is usually secondary in nature, due to a change in the ratio of the processes of production and resorption of amniotic fluid by cells of the amniotic epithelium against the background of kidney or urinary tract damage of the fetus. IUI-induced vascular disorders lead to placental insufficiency.

A typical manifestation of intrauterine infection is miscarriage and premature birth due to the fact that bacterial phospholipases trigger the prostaglandin cascade, and inflammatory toxins have a damaging effect on the membranes. In addition, phospholipases of gram-negative bacteria contribute to the destruction of the surfactant in the lungs of the fetus, which subsequently manifests itself in respiratory disorders in the newborn.

Currently, the following types of intrauterine lesions in IUI are distinguished:

IUI often does not have clear clinical manifestations. Rarely, the first signs in a newborn are present immediately after birth, more often they appear during the first 3 days of life. When infected in the postnatal period, the symptoms of the infectious process are detected at a later date. The clinical appearance of congenital bacterial or mycotic skin lesions in a newborn may have the character of vesiculo-pustulosis. Conjunctivitis, rhinitis and otitis media that appear on the 1st - 3rd day of life can also be manifestations of IUI.

Congenital aspiration pneumonia can also appear on the 2nd - 3rd day of life. From the moment of birth, children show signs of respiratory failure: shortness of breath, cyanosis, often dullness of percussion sound and fine bubbling moist rales. The course of intrauterine pneumonia is severe, since as a result of aspiration, large areas of the lung (lower and middle lobes) are turned off from respiration due to obstruction of the bronchi with infected amniotic fluid containing an admixture of meconium and fetal skin flakes.

Enterocolitis in newborns occurs as a result of the penetration of the pathogen along with the amniotic fluid into the gastrointestinal tract. Dyspeptic symptoms usually develop on the 2nd - 3rd day of life. Characterized by sluggish sucking, regurgitation, bloating, hepatosplenomegaly, expansion of the venous network of the anterior abdominal wall, frequent loose stools. In the microbiological study of intestinal contents, the predominance of Klebsiella, Proteus and Pseudomonas aeruginosa.

The defeat of the central nervous system in IUI in newborns can be both primary (meningitis, encephalitis), and secondary, due to intoxication. With damage to the vascular plexuses of the lateral ventricles of the brain, congenital hydrocephalus develops. It is necessary to pay attention to symptoms such as lethargy, poor sucking, regurgitation, delayed recovery or secondary weight loss, delayed healing of the umbilical wound, the development of omphalitis.

Typical symptoms of infectious intoxication in a newborn are respiratory and tissue metabolism disorders. There is a pale cyanotic coloration of the skin with a pronounced vascular pattern. Intoxication is accompanied by impaired excretory function of the liver and kidneys, enlargement of the spleen and peripheral lymph nodes.

There are 3 stages in the diagnosis of intrauterine infection:

Of the non-invasive methods of prenatal diagnostics of IUI, the most informative are ultrasound and Doppler sonography. Ultrasonic research methods allow to determine indirect signs of fetal IUI: polyhydramnios, ventriculomegaly, microcephaly, hepatomegaly, an increase in the thickness of the placenta, fine suspension in amniotic fluid; and structural changes in various organs.

Direct methods of laboratory diagnostics - cordocentesis, dark-field microscopy, PCR, ELISA (determination of antibodies in the blood to chlamydia, mycoplasma and ureaplasma, CMV and HSV), culture - can detect the pathogen in biological fluids or tissue biopsies of an infected child. Indirect methods for diagnosing IUI include the clinical symptoms of the mother, ultrasound and help to make only a presumptive diagnosis of IUI. Screening tests for IUI in newborns include examinations of smears of amniotic fluid, placenta, cultures of umbilical cord blood and stomach contents of a newborn, and sometimes a culture study of blood. The "gold standard" of post-diagnosis of IUI is the histological examination of the placenta, umbilical cord and fetal membranes.

Any changes in homeostasis in the mother's body are reflected in the cellular and chemical parameters of the amniotic fluid, which very subtly characterize the course of the pathological process, and therefore the amniotic fluid can serve as an important diagnostic material. According to I.V. Bakhareva (2009), the most significant in the diagnosis of IUI is the determination of the antimicrobial activity of the amniotic fluid, based on the migration of leukocytes in it when bacteria accumulate in the amniotic membrane in excess of 10 x 3 CFU / ml. The appearance in the amniotic fluid of a large number of leukocytes, an increase in cytosis due to epithelial cells without the detection of microflora may indicate IUI.

Modern antibiotics are used to treat sexually transmitted bacterial infections. Treatment of infected pregnant women is always subject to certain restrictions due to the adverse effects of antibiotics on the fetus. Antibiotics - macrolides ("new" macrolides) are deprived of this unpleasant property (for example, wilprafen [josamycin]). The treatment of viral infections seems to be more difficult, since they all have the ability to persist for life in the body with periodic reactivation with a decrease in immunity. Despite the extensive list of immunomodulators and immunostimulants, their use during pregnancy is very limited, if not contraindicated. Newer antiherpetic drugs also have limited use in pregnant women and newborns.

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 intrauterine development or during childbirth. We will discuss the signs and methods of diagnosing such diseases 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 mental and physical defects. 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 minimal danger to her child.
The causative agents of the infection pass from mother to baby in 10 cases of pregnancy out of 100.
0.5% of babies infected in utero 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 baby has a chance to be born healthy.
A number of infectious diseases that do not promise anything good to the baby can be present in the mother in a latent form and practically do not affect her well-being in any way.
If a pregnant woman gets sick with this or that infectious disease for the first time, it is highly likely that the child will also be infected from her.

Intrauterine infection - ways of infection of the embryo

There are four ways in which infectious agents can enter tiny growing organisms:

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

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

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

gestation period 3 - 12 weeks: spontaneous termination of pregnancy or the appearance of various developmental anomalies in the fetus;
gestation period 11 - 28 weeks: the fetus is noticeably behind in intrauterine 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 greatest danger of infection is for the central nervous system, heart, liver, lungs and organs of vision.

In addition, congenital infection is acute and chronic. 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:

exceeding the norm of daily sleep duration;
poor appetite;
insufficient physical activity, which decreases every day.

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

complete or partial deafness;
deviations in mental health;
pathology of vision;
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 embryo death;
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;
an enlarged liver with jaundice;
pneumonia;
pathology of the heart muscle;
pathology of the eye lens;
microcephalus and hydrocephalus.

Intrauterine infection: who is at risk

Every expectant mother is at risk of being captured by the pathogen, because during pregnancy the defenses of her body are depleted to the limit. But the biggest 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 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 untimely discharge of amniotic fluid;
have had a pregnancy with abnormal development of the embryo or intrauterine fetal death in the past;
have already given birth in the past to a baby with signs of infection.

Symptoms of intrauterine infection in a woman during pregnancy

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

a sharp rise in temperature, fever;
shortness of breath when walking or climbing stairs;
cough;
rash on the body;
enlarged lymph nodes that are painful to touch;
tenderness in joints that look swollen;
conjunctivitis, lacrimation;
nasal congestion;
painful sensations in the chest.

Such a set of indications may also indicate the development of allergies in a pregnant woman. In this case, there is no threat of infectious 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.

The reasons for the development of intrauterine infection during pregnancy

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

One way or another, but intrauterine infection of a baby comes 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 ectopia of the cervix, urethritis, cystitis, pyelonephritis.
The mother has an immunodeficiency state or HIV infection.
An organ and tissue transplant that a woman has undergone in the past.

Intrauterine infections: main characteristics and routes of infection

Cytomegalovirus (CMV)

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

With the initial infection of a woman in position, the microorganism enters the placenta and infects the fetus. In some cases, no abnormal consequences are observed in the baby after infection. But at the same time, statistics say: 10 out of 100 babies 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;
being underweight at birth;
hydro- and microcephaly;
pneumonia;
lag in the development of psychomotor skills;
pathological enlargement of the liver and spleen;
blindness of varying severity.

Cytomegalovirus under a microscope

If the infectious lesion has a general combined character, more than half of the babies 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 still no medications that could eliminate the symptoms of CMV in newborns. If a woman in a position has been diagnosed with cytomegalovirus infection, the pregnancy is left as the child has a chance to stay healthy. The expectant mother will be prescribed an appropriate course of treatment in order to mitigate 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 is diagnosed with herpes simplex virus type 2, which in most cases is infected during unprotected sexual intercourse. Symptoms of the disease will appear in a child almost immediately, during the first month of life. Infection of a baby occurs mainly during childbirth, when it moves along the birth canal of an infected mother. In some cases, the virus enters the fetus through the placenta.

If the child's body is affected by 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 infections result in oligophrenia, cerebral palsy and a vegetative state.

Herpes simplex virus under a 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:

underweight at birth;
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 can 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 vulnerable to this infection.

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

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

Intrauterine infection - chickenpox

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

Congenital chickenpox is identified by the following features:

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

Newborn babies infected in the womb are not treated for chickenpox, since the clinical picture of the disease does not progress. If a pregnant woman "caught" the infection 5 days before delivery 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 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 as follows:

hepatitis B, which, with the appropriate approach, is treatable;
oncological diseases of the liver;
a 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 special immune lymphocytes. In most cases, infection occurs during intercourse with a sick partner. A child can become infected while in the womb, or during childbirth. Intensive complex treatment is shown to HIV-infected children, otherwise they will not live even two years - the infection quickly "eats up" the weak body. Infected babies die from infections that are not fatal 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 an 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 bacterium listeria. The microorganism easily penetrates 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. An infected baby has the following signs of listeriosis:

rash and multiple accumulations of pustules on the skin;
inflammation of the brain;
refusal to eat;
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 confirmation of listeriosis in a pregnant woman, she is prescribed a two-week course of treatment with Ampicillin.

Intrauterine infection - syphilis

If a woman in a position is sick with syphilis, which she has not treated, the likelihood of infecting her child is almost 100%. Of the 10 infected babies, only 4 survive, and the survivors are diagnosed with congenital syphilis. The child will become infected even if the mother's disease is latent. 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;
mental retardation;
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 during the preparation of dinner. Infection during pregnancy poses a great danger to the intrauterine development of the baby - in 50 cases out of 100, the infection overcomes the placental barrier and affects the fetus. The consequences of infection in a child are as follows:

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

Cytomegalovirus, rubella, toxoplasmosis, herpes, tuberculosis, syphilis and some other diseases are combined into the group of so-called TORCH infections. When planning a pregnancy, expectant 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 are convinced that she is healthy. Women in position take a blood test for hepatitis B and C, syphilis. In relation to pregnant women, the OCP method is also practiced, thanks to which it is possible to identify 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 of great importance for the successful management of pregnancy. This method is absolutely safe for the fetus. And although this procedure is not directly related to the diagnosis of infectious diseases, with its help, doctors can detect intrauterine growth abnormalities caused by pathogenic microorganisms. There is every reason to talk about an intrauterine infection if the following symptoms became apparent on an ultrasound scan:

Formed developmental pathologies.
Polyhydramnios or low water.
Swelling of the placenta.
Enlarged abdomen and abnormally enlarged structural units of the kidneys.
Enlarged internal organs: heart, liver, spleen.
Foci of calcium deposits in the intestines, liver and brain.
Enlarged ventricles of the brain.

In the diagnostic program of examination of expectant mothers belonging to the risk groups, which we spoke about above, a special place is occupied by the seroimmunological method for the determination of immunoglobulins. As needed, physicians resort to amniocentesis and cordocentesis. The first method of research is to study the amniotic fluid, the second involves the study of umbilical cord blood. These diagnostic methods are highly 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.