Chlamydia symptoms in pregnant women. Chlamydia treatment during pregnancy. What are the consequences of a severe form of chlamydia

19.04.2019

Permanent relationship, long-awaited pregnancy and registration in antenatal clinic and ... dozens of tests for genital infections. Why is this needed? - many women are perplexed.

Many expectant mothers are confused by the very possibility of detecting chlamydia infection during pregnancy. However, there is nothing strange about this. According to statistics, more than 10% of pregnant women are carriers of chlamydia.

The discovery of chlamydia during pregnancy does not in any way mean that the woman was leading a disorderly sex life... This infection is found in 60% of men and 70% of women. of childbearing age, and only two-thirds of them suspect the presence of an infection in their body. The rest of the patients find out about her only during a routine medical examination or registration for pregnancy in a antenatal clinic.

At the same time, chlamydia during pregnancy is not something out of the ordinary. This is what makes it different from other STIs - the infection is so widespread and has such insignificant symptoms that it is often begun to be treated only after accidentally detecting traces of pathogenic microflora or other analyzes.

A smear for genital infections - mandatory procedure for pregnant women

Chlamydia bacteria in pregnant women provoke the same processes as in other women. Entering the cells of the body, they lead a secretive lifestyle - about 70% of patients do not even suspect that they are developing. Meanwhile, chlamydia and pregnancy are by no means a favorable combination. According to gynecologists and urologists, more than 50% of all health problems of a future baby are associated with this microorganism.

Danger to the expectant mother and baby

The most popular question for expectant mothers is what is the danger of chlamydia in women during pregnancy? They ask it in most cases after the infection was detected when registering with the antenatal clinic. Unfortunately, many do not take the disease seriously, arguing about the relative safety of the infection, since it does not cause any inconvenience, that is, it proceeds in hidden form... However, one should not hope for a good neighborhood with chlamydia.

Treatment options for pregnancy

Chlamydia can be cured during pregnancy in a relatively short period of time. With a competent approach, this process usually does not cause difficulties. To begin with, the doctor finds out which organs and tissues have suffered from the activity of chlamydia, what symptoms occur, and to which drugs microorganisms are sensitive.

You can treat chlamydia during pregnancy with medications that your doctor recommends.

With inflammation of the mucous membranes (vulvitis, vulvovaginitis, endocervicitis), local treatment with antibacterial drugs is used while taking antibiotics approved for use during pregnancy. With inflammation of the appendages, chlamydia in pregnant women is treated only with antibiotics that do not penetrate through placental barrier(to reduce the negative effect on the fetus).

Chlamydia during pregnancy is enough serious illness... It belongs to the group of sexually transmitted diseases. An unpleasant feature of this disease is that for a long period of time the virus can exist in a woman's body without showing itself in any way. Accordingly, due to the absence of any symptoms, a person does not go to doctors. Meanwhile, the virus actively infects all human body... Therefore, it is so important to have time to detect the problem in time and start treatment as early as possible.

Why is chlamydia dangerous during pregnancy

Chlamydia and pregnancy are poorly compatible things, therefore, as mentioned earlier, it is better to diagnose and cure the disease long before pregnancy, in order to avoid many problems.

Actively multiplying chlamydia can manifest itself vaginal discharge, pain in the genital area and concomitant inflammatory processes, such as pyelonephritis, inflammation of the cervical canal and uterine appendages, conjunctivitis, inflammatory processes of the joints, lesions of the circulatory, nervous, respiratory systems.

In either case, the signs of chlamydia during pregnancy are depending on the site. genitourinary system affected by them.

With an inflammatory process that occurs in the lower parts of the genitourinary system, caused by chlamydia, in pregnant women development is underway infections urethra and vulvovaginitis. This causes pain, burning and itching when urinating, discharge. If pseudo-erosion occurs in pregnant women, this is accompanied by bleeding of the cervix, the appearance of bloody discharge.

If the infection spreads in an "ascending" way, the cervical canal, appendages, uterus become inflamed, which is accompanied by pain in the lower abdomen, back, and bleeding. The temperature may rise, signs of intoxication will appear.

Very often, chlamydial infection in expectant mothers runs latently, thereby negatively affecting pregnancy.

Chlamydia during pregnancy pose a serious risk to the health of the pregnant woman and the fetus. They provoke various complications and are a common reason that a woman cannot bear a child. This happens depending on the duration of the pregnancy and related factors. On early dates it is a threat of miscarriage, termination of pregnancy. In the case when the pathogen penetrates the uterine mucosa, secondary placental insufficiency can develop: against the background of the formed placenta, oxygen starvation of the fetus appears.

With this pathology, chlamydia is the cause of the formation of pathogenic immune complexes, due to which the respiration and nutrition of the fetus is disturbed, which can cause its death.
For more later dates against the background of toxicosis, the possibility of premature birth is not excluded.

Chlamydia during pregnancy is fraught with placental abruption and rupture fetal membranes, abundant water and weak generic activity.

Intrauterine infection There can be no chlamydia of the fetus, since anti-Chlamydia antibodies are present in the mother's blood, which protect the baby.

The infection is transmitted from mother to child during childbirth, when the child passes through the birth canal carrying the infection. Once on the baby's mucous membranes, chlamydia can cause an infection in him. respiratory tract, pneumonia, etc.

The consequences of the vital activity and activity of chlamydia in the body of a pregnant woman can be as follows:

Freezing early pregnancy, as well as the loss of a child;
Pronounced toxicosis that haunts the expectant mother;
Inflammatory processes of the uterine membranes;
Inflammatory processes of the amniotic membranes, which complicate normal development fetus;
The appearance of anemia;
High water;
Great chance premature birth;
In half of the cases, babies are born premature;
Pathologies of the ocular mucous membranes are possible.

A woman carrying the virus may well infect a baby while still in the womb. Most high risk infection during childbirth, when the child will overcome the birth canal. The acquired infection is very dangerous for newborns and can even be fatal.

Chlamydia after childbirth, what is dangerous

As a rule, at 2-6 weeks after childbirth, a woman suffering from chlamydia often develops endometritis with not pronounced inflammatory phenomena. Usually, the only manifestation of inflammation of the uterine mucosa is a small but prolonged increase in temperature, accompanied by a reverse delayed development of the uterus.

The chronic form of chlamydial infection in the future can threaten with a violation of the patency of the fallopian tubes, which means ectopic pregnancy and infertility.

Not all antibacterial drugs are suitable for the treatment of chlamydia during pregnancy. The use of antibiotics of the tetracycline group is usually accepted, but this is highly undesirable when carrying a child. Preferred are antibiotics harmless to the fetus, the molecular weight of which is greater than the "throughput" of the capillaries. But even these antibiotics can affect the fetus. Therefore, antibiotics from the macrolide group are used to treat chlamydia in pregnant women. Along with them, funds are prescribed to eliminate dysbiosis and restore the microflora of the vagina, as well as drugs that stimulate and strengthen the immune system.

Difficulties in the treatment of this disease lie in the fact that often chlamydia does not come alone. It gets along well with other sexually transmitted diseases, which greatly complicates the selection of adequate therapy. Moreover, the weakened body of a woman during pregnancy gives an excellent opportunity for infection to lead active life and bring a lot of trouble, since the immune system is not able to resist it. So you need to be patient and get ready for long-term treatment.

Get ready for the maximum frank conversation with a venereologist. This is the first, important stage in your treatment. Do not try to lie or sugarcoat reality - do not forget that doctors are faced with different situations every day, and you are unlikely to pique their particular interest. But for you, omissions can be expensive. After all the nuances have been clarified, you will be assigned a series of analyzes for chlamydia, which are necessary for an accurate diagnosis. Then you can leave the treatment.

Your doctor should take a swab of mucus from your vagina, which can make you uncomfortable - another symptom of an infection.

Please note that the analysis for chlamydia in some cases will have to be taken several times and to both partners. This is necessary to exclude medical error... Treat this with understanding - you do not want to treat something wrong. And by the way, both partners will also have to be treated.

Chlamydia treatment cannot be complete without antibiotics. Your doctor will select the most gentle program for you and your baby. Stay Healthy!

Chlamydiae are absolute pathogens and normally cannot be present in human tissues and organs. The latent course of the disease allows pathogens to remain unnoticed for a long time. but thorough examination women during pregnancy does not allow such dangerous infection... What is the most accurate analysis for chlamydia during pregnancy, how the disease threatens and how to get rid of it?

There are about six to eight varieties of chlamydia, but two species are dangerous to humans - Chlamydia trachomatis and Chlamydia pneumonia. The latter is the cause of atypical pneumonia, including in pregnant women. But more often one has to deal with Chlamydia trachomatis, which lives in the genitourinary tract of men and women, and immune complexes to it can circulate in the blood. It is for this type of chlamydia that screening is carried out during gestation.

What kind of pathogen

A feature of microorganisms is their ability to pass into "dormant" L-forms. Moreover, they are inside the cells (most often of the genitourinary system), pass from one to another during division, but are not recognized in any way the immune system person. And only under "convenient" conditions are they activated and cause clinical symptoms inflammation.

The statement that chlamydia like the herpes virus is constantly present in the body, but is activated in special periods is not entirely true. In the absence of treatment or non-compliance with the schemes and doses, "latent" forms continue to be in human cells, creating the appearance of well-being. This is a chronic variant of the disease, but in no way a variant of the norm.

How is it transmitted

The "favorite place" of chlamydia is the mucous membranes of the genitourinary tract. Therefore, the main route of transmission is sexual, including not only vaginal, but also anal, oral contact. The incubation period of the infection can be up to two months, the symptoms are often extremely meager.

In addition, a contact-household transmission route is possible in close contact with the secretions of other people. Greatest risk associated with visiting baths, saunas. Infection through unwashed hands is also possible, and both a clinical picture of inflammation of the genitourinary system and conjunctivitis, including in children, can occur. Newborns can become infected from a sick mother when passing through the natural birth canal.

Before or during gestation

When chlamydia is detected during gestation, the question naturally arises when the infection arose, which has not only clinical significance, but also social - this is serious threat family relations... The algorithm is approximately the following. If the woman has been previously examined:

chlamydiae have been found- it is possible that the woman was poorly treated before pregnancy or pathogens turned into L-form, as a result, they can be re-identified during gestation;
no chlamydia- the detection of microbes during gestation indicates infection during or after conception.

If a woman has never been examined for chlamydia before, it is impossible to indicate the time of infection, given that the disease can long years proceed in a low-symptom form. However, it should be borne in mind that in this case, chlamydia very often leads to infertility due to the tubal factor - adhesions are formed and obstruction occurs.

Airborne transmission is characteristic only for Chlamydia pneumonia with the onset of symptoms of acute respiratory disease. For infection with Chlamydia trachomatis, contact with human body fluids, in which the pathogen is located, is necessary.

Chlamydia manifestations during pregnancy

Most often, chlamydia is an "accidental" finding during a detailed examination of a pregnant woman. Sometimes the following facts are markers of the presence of infection:

recurrent vaginal inflammation- during examination, leukocytes are increased in ordinary smears, gardnerella, yeast fungi are present, coccal flora predominates;
signs of insufficient fetal growth- according to the results of ultrasound, there is a growth retardation for two or more weeks, there are symptoms of intrauterine infection;
bearing pathology- threats of termination of pregnancy, chorionic detachment, leakage of amniotic fluid or premature birth- all this is an indication for additional / repeated examination for chlamydia.

First of all, chlamydial infection is localized in the vagina and cervix, especially if the infection occurred during gestation. Therefore, the clinic is dominated by following symptoms chlamydia during pregnancy.

Colpitis. The amount of leucorrhoea increases, they are light milky, without a special smell, they resemble "cream". Itching, burning, redness of the external genital organs due to irritation with secretions may join.
Cervicitis. The woman does not feel inflammation of the cervix and cervical canal. However, with a gynecological examination, redness and increased tissue vulnerability can be detected.
Urethritis and cystitis... Chlamydia can manifest itself in the form of frequent and painful urination, pain in the lower abdomen due to inflammation of the bladder.
Defeat oral cavity ... Chlamydiae can also inhabit the oral mucosa. The clinical picture corresponds to gingivitis, glossitis, pharyngitis and is accompanied by pain, ulcers, unpleasant odor from mouth.
Pneumonia . With a serious decrease in immunity, for example, against the background of HIV, atypical pneumonia with mild symptoms and signs on X-ray examination are possible.

Other complications of chlamydia such as trachoma (damage to the lining of the eye), Reiter's disease (involvement of the joints) are more common in non-pregnant women.

Why is it dangerous

Chlamydia is more dangerous for a child, as it can affect his normal development. For a woman, the risk of postpartum complications increases.

For the fetus

The main consequences of chlamydia during pregnancy for a child:

in the early stages- freezing of the development of the embryo, the threat of interruption, chorionic detachment, with chlamydia, the likelihood of malformations increases, as well as ectopic location fetal egg(ectopic pregnancy in women);
at a later date- lagging behind in the growth and development of the fetus, impaired functioning of the placenta, the likelihood of late miscarriages, polyhydramnios, leakage of amniotic fluid and premature birth;
after birth - every fifth baby born to a woman with chronic chlamydia develops eye inflammation (conjunctivitis), every tenth child has atypical pneumonia, especially often such complications develop in premature babies.

In addition, there may be intrauterine infection, inflammation of the placenta (chorioamnionitis), which can pose a threat not only to the life of the child, but also to the woman.

For woman

During pregnancy, chlamydia, in addition to the troubles associated with colpitis, are fraught with the development of a conjunctivitis clinic if personal hygiene is not observed. For a woman, untreated chlamydia is most often fraught with the following complications after childbirth:

endometritis - inflammation of the uterine cavity, which is accompanied by a violation of its contractility and prolonged involution (recovery);
seam divergence- the likelihood of suppuration of vaginal and perineal wounds increases, followed by poor healing.

If chlamydia is in the urine excretory systems e women, after childbirth, the frequency of cystitis, urethritis and even pyelonephritis increases. Ignoring the problem in the future can lead to Reiter's disease (joint damage), trachoma (eye disease).

What tests need to be passed

Given that chlamydia is dangerous during pregnancy, its diagnosis should be taken seriously. For the detection and subsequent treatment of chlamydia, one type of examination is sufficient - polymerase chain reaction (PCR), preferably its variety - real-time PCR. The latter helps to make the study more accurate and exclude overdiagnosis associated with the detection of "dead chlamydia".

Polymerase chain reaction

PCR analysis is submitted at any time. The collection of material (scraping, better known as a "smear", which is not entirely true) is carried out from the following places:

urethra;
cervix;
the posterior fornix of the vagina.

The detection of even single microbes is considered positive. A negative result confirms the complete absence of chlamydia in the body.

Linked immunosorbent assay

The ELISA method is often used to diagnose chlamydia. The study involves the collection of venous blood and the determination of antibodies to pathogens - Ig G and Ig M. The result can be interpreted based on the following table.

Table - How to correctly understand the result of the analysis for chlamydia

Ig M	Ig G	Decryption
Positive	Negative	- The result is typical for acute chlamydia, which is most dangerous during pregnancy
Positive	Positive	- Appears when under acute infection
Negative	Positive	- The result is possible with chronic infection flowing over the years; - also typical for those who once had been ill and cured chlamydia completely
If not define	Positive	- Positive credits may indicate both previous infection in the past and active at the moment; - for clarification, it is necessary to track the increase or decrease of the titer with an interval of 4-8 weeks
Negative	Negative	- Indicates that the woman has never had an infection

It is often possible to face the fact that only when a positive Ig G ("chlamydia in the blood") is detected during pregnancy, antibacterial treatment is prescribed according to the standard scheme. However, such an immune status may indicate a once transferred disease, and not an active infection.

Other methods

Chlamydia can also be suspected or detected by other methods, however, due to the high cost and duration of studies, they are used extremely rarely in atypical cases of infection.

The following analyzes can be applied:

immunofluorescence reaction (RIF);
bacteriological inoculation.

A standard smear can only show the presence of inflammation in the vagina, urethra and cervix, but the pathogen cannot be identified in this way.

What to do when detected

The question that the treatment is not necessarily subject to doubt, however, only when it is confirmed. There are no doubts and debates here, as, for example, with mycoplasmosis or ureaplasmosis. Chlamydiae are unambiguously classified as pathogens and should not normally be detected. Absolute indications for starting therapy during gestation:

detection of chlamydia by PCR;
detection of Ig M in blood by ELISA study.

When to heal

The question of when to start treatment for chlamydia during pregnancy so that the drugs do not have serious consequences for the development of the fetus remains controversial. It is generally accepted to start antibiotic therapy as safe from 16-20 weeks. However, in the case of acute or complicated chlamydia (for example, against the background of a threat, hematoma) wait and see tactics can lead to pregnancy loss.

It is impossible to cure chlamydia without antibiotics. But pregnancy imposes serious restrictions on antibiotic therapy. For example, "Doxycycline" and "Ofloxacin" are prohibited for treatment during gestation, as they cause impaired development of bones and teeth in the fetus. What means are permissible for use, the table shows.

Table - Approved drugs for the treatment of chlamydia during gestation

A drug	Destination scheme	1 trimester	2 trimester	3 trimester
"Azithromycin"	- 1 g once	- According to strict indications	- Allowed
"Erythromycin"	- 500 mg 4 times a day for a week	- Use is undesirable, but possible	- Allowed
Wilprafen (Josamycin)	- 750 mg 2 times a day for 1-2 weeks	- Safe for use at any time
"Amoxicillin"	- 500 mg three times a day for a week	- Allowed for strict indications		- It is advisable not to use from 32 to 35 weeks, as the frequency of colitis in newborns increases

Depending on the timing and in what situation the treatment is carried out, vaginal suppositories can be additionally prescribed, as well as drugs to support pregnancy (for example, "Duphaston"). When treating chlamydia in a woman important point is the sanitation of the sexual partner. Schemes and doses of drugs are similar. Sexual intercourse is possible only after a full course of therapy and control of cure.

Monitoring therapy

There is no need to doubt whether chlamydia is treated during pregnancy. If all recommendations are followed, the infection passes without significant complications for the mother and fetus. After treatment, it is necessary to control the cure. To do this, it is recommended to take a PCR test - a woman and her sexual partner no earlier than a month after taking the last pill.

ELISA study in in this case not always informative. The effectiveness of therapy can be judged by decreasing antibody titers, but sometimes their level remains constant with complete absence infections.

What if ignored

Some women refuse to take antibiotics during pregnancy even with chlamydia. In these cases, they risk the baby's health and their lives. Chlamydia in women in 70% of cases leads to various complications gestation and infectious pathology of the newborn.

Chlamydial infection is not uncommon among women who are expecting a baby. In most cases, the disease is asymptomatic, causing various pathologies during pregnancy. What is the threat of chlamydia to expectant mothers?

The reasons for the development of chlamydia

The disease is transmitted sexually and through household contact. The inflammatory process in the genital tract causes Chlamydia trachomatis. This microorganism prefers columnar epithelium - the mucous layer lining the urethra and cervix. In addition, chlamydia can settle on the conjunctiva of the eyes or in the nasopharynx. In little girls, microorganisms are found on the vaginal mucosa.

Long-term study of the infection showed that against the background of infection with chlamydia there is a sharp decrease in protective properties organism. This explains the frequent transition acute illness v chronic form... Chlamydia is often combined with other inflammatory processes of the genital tract, which leads to the appearance of symptoms that are not at all typical for this infection.

Chlamydia is predominantly sexually transmitted. The risk of infection increases in women with big number sexual partners (both now and in the past). The contact-household route of transmission of chlamydia is quite rare, and is always associated with non-compliance with the rules of personal hygiene. It is possible that the infection from the mother to the newborn during childbirth.

Chlamydia symptoms

Chlamydia is a serious medical condition that can cause various problems during pregnancy. The situation is further complicated by the fact that the infectious process is often asymptomatic for a long time. This leads to late detection of the disease, and as a result, to frequent development complications. In 80% of pregnant women, chlamydia does not manifest itself in any way and becomes an accidental finding during the examination.

Specific symptoms by which it would be possible to determine chlamydia at the first examination, does not exist... The infection can manifest itself as cervicitis (inflammation of the cervical canal). In this case, the pregnant woman will notice the appearance of abundant yellowish discharge from the genital tract. Itching and burning in the vagina, pain during intercourse are possible. With the defeat of the urethra, urination becomes more frequent, false desires appear. The inflammation can also be felt by a burning sensation or pain when passing urine.

Chlamydial infection in pregnant women rarely occurs with an increase in body temperature. With eye damage, conjunctivitis develops. There is lacrimation, pain and itching in the eyes, intolerance to bright light sources. If chlamydia makes its way into the nasopharynx, pharyngitis develops with strong cough and a runny nose. In pregnant women, these symptoms are rare. Damage to the eyes and nasopharynx is typical for newborns and young children.

Chlamydia in postpartum period can make itself felt by the development of endometritis. Inflammation of the lining of the uterus manifests itself in the form of an increase in body temperature up to 38-40 ° C. Arise severe pain lower abdomen, abundant purulent discharge from the genital tract. Such signs appear 5-10 days after the birth of the child and are considered sufficient severe complication postpartum period.

Chlamydial infection can be exacerbated after abortion and other interventions in the uterine cavity. Symptoms of the disease do not differ from those of postpartum endometritis.

Chlamydia diagnosis

Chlamydial infection is difficult to recognize during gynecological examination, therefore, to detect it great importance have laboratory methods... To identify chlamydia, a scraping is taken from the mucous membrane of the cervix and urethra. V special cases material for analysis can be taken from the rectum, as well as from the mucous membrane of the eyes and nasopharynx.

There are certain rules for taking material for the determination of chlamydia:

the patient should not take a shower for 24 hours before the examination;
local therapy(vaginal suppositories) should be discontinued 48 hours before sampling;
antibiotic intake ends 4 weeks before the planned study.

Failure to follow these rules may result in incorrect results and unwanted interpretation.

To determine chlamydia is used PCR method(polymerase chain reaction). This method allows you to accurately determine whether there are infectious agents in the body of a pregnant woman. The PCR method does not give quantify result, but only shows the very fact of the presence of infection. For chlamydia, this is quite enough. The causative agents of the disease should not be present in the body healthy woman, which means that any number of them requires treatment.

To establish the exact volume of microorganisms, ELISA(linked immunosorbent assay). This method allows you to find out what antibodies are present in the body. future mother... The detection of class G immunoglobulins suggests that a woman has had chlamydia in the past, and now she has immunity against this infection. The appearance of class M immunoglobulins indicates either an acute infection or an exacerbation of a chronic process. In the first case, only M immunoglobulins will be determined. With an exacerbation of a chronic infection, along with M immunoglobulins, class G antibodies will also be present.

All women registering for pregnancy are screened for chlamydia. The sampling of material for analysis is carried out after the first visit. The sooner the infection is detected, the faster the treatment will be carried out. Only timely therapy of the disease will avoid the development serious problems during pregnancy.

What is the threat of chlamydia to a woman?

When a chlamydial infection occurs, problems begin even before the conception of a child. Many women simply cannot get pregnant with chlamydia. This disease, with a long course, leads to the development of chronic inflammation in the fallopian tubes. As a result, adhesions form in the pipes, which leads to their complete or partial obstruction. Chlamydia often becomes the cause of ectopic pregnancy precisely due to the formation of adhesions.

Since the disease long time is asymptomatic, a woman may not know anything about her problem. Inflammation of the uterus and appendages is not always manifested by pain in the lower abdomen or bloody discharge from the genital tract. Often, the disease is detected only after removal. fallopian tube during the examination.

Chlamydial infection is also one of the common reasons infertility. Chlamydia is found in many women who cannot get pregnant for a year. It is this infection that the doctor first of all excludes when a woman who wants to have a child turns to him.

Pregnancy, which occurs against the background of chlamydia, proceeds with complications. In the early stages, it is possible spontaneous miscarriage or at least the threat of termination of pregnancy with constant toning of the uterus. In the second half of gestation, premature births often occur. Chlamydial infection during pregnancy can cause polyhydramnios as one of the manifestations of fetal infection.

The consequences of chlamydia for the fetus

During pregnancy, it is possible for the fetus to become infected with chlamydia located in cervical canal and urethra. In the first trimester of pregnancy, infection often causes miscarriage. Even if the pregnancy can be maintained, it rarely goes well. Formed chorionamnionitis (inflammation of the membranes) further leads to the development placental insufficiency... At the same time, the placenta cannot perform all its intended functions and provide the baby with oxygen and nutrients. Hypoxia develops - oxygen starvation of the fetus. This condition most of all affects the development of the nervous system, leading to the appearance of various neurological disorders in a newborn.

a lack of nutrients, entering through the placenta, also affects the formation of all organs of the baby. In the second half of pregnancy, a delay is often found intrauterine development... This situation leads to the birth of a child with a low body weight, which in the future requires long-term treatment.

The infection of a child does not occur only in the womb. Very often, chlamydia gets to the newborn when it passes through the birth canal. Caesarean section does not prevent infection. Children born by surgery are often infected with chlamydia. In this case, the mucous membrane of the eyes and nose is damaged. In newborn girls, chlamydia settles in the genital tract, causing the development of colpitis.

Chlamydial infection in newborns is rarely limited to rhinitis and conjunctivitis. The inflammatory process can spread to the lungs, causing the development of pneumonia. Other internal organs are often affected: liver, kidneys, stomach and intestines. Suffers and nervous system baby. It is noted hyperexcitability, frequent crying, profuse regurgitation, muscle tone decreases. All of these symptoms are not specific to chlamydia and can occur with many intrauterine infections.

Chlamydia treatment during pregnancy

Chlamydial infection is a disease that should not be left to chance. When chlamydia is detected, therapy is required to destroy the causative agent of the disease. Such measures make it possible to prevent complications of pregnancy and avoid infection of the fetus both in utero and during childbirth.

Chlamydia is not treated in the first trimester... Even if the infection has been detected for up to 12 weeks, doctors prefer to wait and not take any action. Antibiotics prescribed for chlamydia can negatively affect the development of the baby in the first trimester. In this case, the possible risk of treatment outweighs the benefit, and therefore expectant tactics are allowed.

If chlamydial infection is accompanied by copious secretions from the genital tract, local therapy is prescribed in the early stages. In the first trimester, it is allowed to use Fluomisin, Hexicon and Betadine. These vaginal suppositories are inserted into the vagina once a day (preferably at night). Well local treatment is from 6 to 10 days, depending on the drug used.

In most cases, vaginal suppositories are well tolerated by pregnant women. Occasionally, there is an itching or burning sensation in the vagina during treatment. In this case, experts recommend changing the drug to another that does not cause similar reactions.

From 16 weeks pregnant antibacterial agents are added to the treatment of chlamydia. Josamycin, a drug from the macrolide group, has proven itself well. The dosage of the medicinal product is determined by the physician. The course of therapy is 10-14 weeks. Spiramycin or clarithromycin may be used in place of josamycin. All of these products have undergone clinical trials, where their effectiveness has been proven. In the second half of pregnancy, these drugs do not have any negative impact on the condition of the expectant mother and her baby.

As a topical treatment in the second and third trimesters pregnancy is prescribed "Terzhinan", "McMimor", "Klion D100" and other drugs. These funds are also available in the form vaginal suppositories and are applied once at night for 7-10 days. Such drugs affect a wide range of pathogens and can be used for mixed genital tract infections.

After the end of treatment, it is imperative to monitor its effectiveness. 30 days after the withdrawal of antibiotics, PCR or ELISA is done. Retreatment usually not performed during pregnancy. Experts believe that this does not make sense, since chlamydia was not susceptible to approved antibiotics. In this case, treatment resumes after the birth of the child.

In addition to antibiotic therapy, others are prescribed. medicines:

Preparations for stimulating immunity... For this purpose, in the second half of pregnancy, "Viferon" is prescribed. The drug is injected into the rectum once at night. The duration of treatment is 10 days. "Viferon" activates the body's defenses, helping it cope with infection during pregnancy.
Vitamins. Great attention in the treatment of chlamydia is given to the selection vitamin complexes... These drugs not only tone up the body of the expectant mother, but also saturate the baby. useful substances necessary for its development. During pregnancy, it is recommended to take medications specially designed for women in interesting position: "Elevit", "Vitrum Prenatal Forte" and others. This approach to therapy allows you to increase immunity and improve general state pregnant woman.
Mineral complexes... Instead of multivitamins, the gynecologist may prescribe the Femibion mineral complex. This drug is available in two versions - separately for each half of the pregnancy. Femibion is a balanced complex that supplies all the necessary nutrients and vitamins to the body of a pregnant woman. Against the background of its use, there is a rapid increase in fetal weight and growth.
Drugs that improve uteroplacental blood flow... The placenta with chlamydia does not always cope with its function. For prevention oxygen starvation the fetus is prescribed funds that activate blood flow in the placenta. For this purpose, actovegin, pentoxifylline and other drugs are used. The course of treatment lasts from 5 to 10 days.

Do I need to treat a baby with chlamydia?

Chlamydia in newborns is also amenable to antibiotic therapy. For the treatment of babies in the first days of life, erythromycin or other drugs from this group are used. On defeat internal organs therapy is carried out in a hospital setting. Chlamydia obtained from the mother can persist in babies for three years.

Chlamydia treatment is carried out not only for a pregnant woman, but also for the father of her child. If both partners are left untreated, the infection will return soon. For the treatment of men, the same groups of antibacterial drugs are used. The selection of the dosage and control of the effectiveness of therapy is carried out by a urologist or andrologist.

It happens that during pregnancy a woman never finds out about her illness. This happens in expectant mothers who are not registered in the antenatal clinic or who refuse to be examined for chlamydia. If untreated, the baby becomes infected in utero or during childbirth. The infection is detected in a newborn, after which pediatricians begin treatment. At the same time, chlamydia therapy is also prescribed to a postpartum woman who has not received drugs during pregnancy.

How is childbirth with chlamydia?

Chlamydial infection that occurs during pregnancy is not an indication for caesarean section... Childbirth can take place through the vaginal birth canal, if there is no other reason for the operation. Chlamydia has no effect on the course generic process... Doctors are only afraid of infection of the baby during childbirth, so they take all measures to prevent this from happening.

Termination of pregnancy with chlamydia is not carried out. This disease is not an indication for medical abortion... The mother-to-be is notified of possible risks and offer to undergo treatment for chlamydia in the second half of pregnancy.

Chlamydia prevention

Chlamydial infection is a disease that is easier to prevent than cure. There are certain rules to avoid the development of the disease:

loyalty to a partner;
use of barrier methods of contraception (condoms);
compliance with the rules of personal hygiene;
use of individual linen and towels;
timely treatment of sexually transmitted infections.

Women planning a pregnancy should be screened for chlamydia with their partner. If an infection is detected, future parents should go through full course treatment before pregnancy. Such a measure is guaranteed to protect a woman and her baby from the serious consequences of chlamydia.

Chlamydia is an infection that occurs in many women during pregnancy. If all the doctor's recommendations are followed, the expectant mother has a chance to give birth healthy child. Timely diagnostics and treatment of chlamydia can help avoid infection of the fetus and the development of serious health problems in the newborn.

What causes the disease

Chlamydia can be transmitted to living conditions... On given path transmission accounts for no more than 5% of infections. Chlamydiae during pregnancy penetrate into amniotic fluid, after which the fetus is affected. Ingestion of amniotic fluid contributes to infection.

it is possible, however, the disease must be cured before conception. This is the only way a woman will have every chance of giving birth to a healthy child. During the planning period of pregnancy, it is necessary to pass the appropriate tests. If the pregnancy has already begun, such an examination is included in the standard scheme for its management. Chlamydial infection is currently being treated without any consequences for the unborn child.

Bacteria enter the human body through close contact with the mucous membranes of the infected. After a while, they infect immune and epithelial cells, where they stay for 3-5 years. After a few days, human immunity recognizes the infectious agent and begins to produce. As a result, an acute inflammatory process... Its intensity can vary.

How does an infection manifest during pregnancy?

In most cases, the disease is latent. This is why chlamydia is dangerous. More than half of women are unaware that they are infected. In other cases, chlamydia has mild symptoms:

The signs described above may indicate not only chlamydia, but also other infections of the genitourinary system. Typical signs that help to recognize the disease does not exist. However, this is not a reason to refuse the survey. The presence of the above unpleasant sensations should force a woman to see a doctor.

Why is the disease dangerous?

At improper treatment chlamydia has negative impact on the body of a woman and her unborn child. Against the background of this infection, an inflammatory process develops in the small pelvis, which can result in peritonitis. is one of the most common complications of chlamydia. In this case, the joints and organs of vision are affected. Narrowing of the urethra contributes to the disruption of the processes of urine excretion.

Elevated muscle tone- one of the least dangerous complications found in a child born to a patient with chlamydia of matter. In other cases, severe lesions of the central nervous system are detected. With pronounced hypoxia, the child is born dead. The consequences for the child can manifest itself in the form of a lack of nutrients. The fruit has low weight and signs of iron deficiency anemia.

In the later stages, chlamydia penetrates the child's body. Most often, damage to the digestive and excretory systems is found. The risk depends on the severity of the disease. lethal outcome... Timely treatment can help reduce the risk of complications.

Congenital chlamydia in children is manifested by:

conjunctivitis;
pneumonia;
encephalopathy;
convulsive syndrome.

Most dangerous consequence chlamydia is Fitz-Hugh-Curtis disease, which combines hepatitis, ascites and peritonitis.

How is the disease detected

To identify chlamydia in the blood during pregnancy on this stage the development of medicine is not difficult. Immunological and serological tests can detect both the causative agent of the infection itself and antibodies to it. To begin with, a swab is taken from the vagina, cervix or urethra. At positive result analysis, a blood test is performed.

In certain cases, it is necessary to know if the fetus is infected. For this, amniotic fluid is taken. Pregnant women are afraid of this procedure, but it is not considered dangerous for the unborn child. The material is taken under ultrasonic control. There is a certain risk, but it is assessed as insignificant. Amniocentesis allows you to detect the disease in time and protect the child from its negative consequences.

Therapy

Treatment of chlamydia during pregnancy begins with the identification of concomitant infections that are no less dangerous than the underlying disease. It is necessary to carry out tests for:

syphilis;
ureaplasmosis;
herpes;
cytomegalovirus.

Based on their results, a comprehensive therapeutic scheme is drawn up. Diagnostics is equally important. noncommunicable diseases such as renal or hepatic impairment. The use of drugs can negatively affect the general condition of the body and disrupt the functions of internal organs.

Therapy should be supervised by a physician. Do not stop it after the symptoms of infection have disappeared. Chlamydiae remaining in the body develop resistance to the antibiotic used, which makes it almost impossible to completely get rid of the disease. Not all drugs used to treat chlamydia are suitable for pregnant women. For example, antibiotics of the tetracycline series are contraindicated, which have a large amount side effects... The safest are macrolides.

It is strictly forbidden to take medications on your own. Only experienced specialist can select the most safe medicines for mother and child.

May mean a single dose of a drug to which chlamydia has increased sensitivity. Complex therapy includes the intake of enzymes and immunostimulants. All medicines are selected taking into account the characteristics of the body, the duration of pregnancy and the presence of certain symptoms. Immunomodulatory agents are not always used. The need to take them is determined by the results of the immunogram.

Enzymes play an important role in eliminating chlamydial infection. With their help, the permeability of cell membranes is normalized and the risk of occurrence allergic reactions for drugs. In addition, enzymes have analgesic and anti-inflammatory effects. To determine the effectiveness of treatment, control tests are carried out.

Preventive measures

It implies the rejection of casual intimate relationships and the use of barrier methods of contraception. A condom should also be used when a woman is unsure of her husband's health. Regular tests for chlamydia are required. The disease during pregnancy is not uncommon, it is found even in women living in normal social conditions.