Streptococcus hemolyticus in the urine of a pregnant woman. Consequences and treatment of streptococcal infection after childbirth. Urine test for infection in pregnant women

20.04.2019

The microflora of the vagina is represented by a variety of microorganisms. Depending on their relationship, the concept of norm and pathology is distinguished. The basis of the normal flora is made up of sticks - lactobacilli. They are supplemented by conditionally pathogenic microorganisms, represented by streptococci, staphylococci, gardnerella, candida, urea- and mycoplasmas.

As long as the number of these microorganisms is negligible, no a large number leukocytes, the condition of the vagina is considered satisfactory. If one of them predominates in a smear from the cervical canal, for example, streptococcus agalactia, then nonspecific inflammation is diagnosed.

A little about the pathogen

Streptococci are large group microorganisms that are morphologically similar. Depending on the nature of growth on nutrient media, serogroups are divided into hemolytic, green and non-hemolytic. In the vagina there are groups B, D and green. The norm indicators should not exceed 10 to the 4th degree CFU / ml.

Agalactia belongs to group B beta-hemolytic streptococci. This means that when sown on a nutrient medium based on agar and blood, as the colony grows, a zone of complete hemolysis of erythrocytes forms around it. Wherein nutrient mixture discolored.

The activity of the microorganism is accompanied by the release of various toxic substances:

streptolysin destroys surrounding tissues;
leukocidin destroys immune cells, allows microbes to escape from it;
necrotoxin and lethal toxin cause tissue necrosis;
a set of enzymes that help streptococcus invade surrounding tissues: hyaluronidase, proteinase, amylase, steptokinase.

The settlement of streptococci occurs with the period of puberty and the onset of sexual activity. A household route of transmission is possible when using common hygiene items. Women are able to self-infect themselves if, when washing the genitals, the movements are directed from back to front. Microbes from the anal folds enter the vagina. A pregnant woman during childbirth is able to infect her child.

Men can become infected from women during oral or anal sex, through the walls of the intestine with dysbacteriosis, descending from the kidneys or nasopharynx.

What are the signs of an infection?

Until the moment when the amount of the pathogen is at a minimum level, there are enough lactobacilli in the vagina that inhibit the growth of opportunistic flora. In men, streptococcus agalactia appears after unprotected intercourse. In the future, they become carriers of the infection and are able to betray the pathogen to other partners.

Streptococcus activation occurs when the balance of normal microflora is disturbed. The following reasons lead to this:

hormonal changes;
decreased immunity;
violation of hygiene procedures;
use of douching for personal hygiene;
diabetes mellitus and severe pathologies.

During pregnancy, the first two factors are especially relevant. , which gradually rises, depresses local immunity. This process is aimed at maintaining pregnancy, but it has Negative consequences: in pregnant women, latent infections of the genitourinary organs often worsen, and colpitis develops.

There are no symptoms of agalactia. These pathogens do not cause an inflammatory reaction of the vagina. Detection of a high concentration of the pathogen occurs by chance when scheduled inspection. In pregnant women, signs of activation of the infection appear in the form of urethritis or cystitis.

Initially, the pathogen appears in the urethra, and then rises higher. characteristic symptoms cystitis are pain and burning sensation when urinating, then a feeling incomplete emptying Bladder, frequent urges, which are not accompanied by the release of large amounts of urine.

Acute cystitis is accompanied by deterioration of the general condition, weakness, headache. Temperature rise is rare.

What is the danger of infection?

Streptococcus agalactia during pregnancy is detected in 20% of women. Lack of timely treatment can lead to the development of the following complications:

urinary tract infection;
postpartum endometritis;
sepsis of the neonatal period;
pneumonia of the newborn;
endocarditis;
meningitis.

For a woman, in most cases, the infection will be hidden; in a newborn, it often causes complications.

In what cases is an examination necessary?

There are certain risk groups for development streptococcal infection:

long anhydrous interval of more than 18 hours;
rise in body temperature in a woman in childbirth;
bacteria in urine
the birth of a premature baby;
small weight of the newborn;
childbirth through .

If a woman had a child with streptococcus agalakia in previous pregnancies, then examination in the second birth is mandatory.

Laboratory diagnostic methods

In a planned manner, pregnant women perform smears from the cervical canal. This research method allows you to determine the degree of purity of the vagina and establish the first deviations from the norm. If the smear is dominated by coccal flora, culture is necessary, which is the main method for diagnosing infection.

For sowing, liquid or solid nutrient media are used. In some laboratories, substances are added to them that inhibit the growth of other microorganisms. This increases the excretion of streptococcus by 50%.

For sowing, the material is taken from the vagina, anorectal region. It is recommended to take discharge from several sections of the mucosa at the same time. It also increases the likelihood of identifying the pathogen. The detection of 10 to the 3rd degree CFU / ml is a variant of the norm.

Since the role of streptococcus agalactia in infection of the newborn is very large, a system of screening tests has been developed to detect agalactia. To do this, use the determination of microorganism antigens in latex agglutination, ELISA, coagglutination. These methods are fast but have some drawbacks. If you conduct a study during childbirth, then the discharge from the vagina can be mixed with amniotic fluid, blood. This reduces the sensitivity of the tests.

PCR diagnostics is also used. With its help, it is possible to isolate streptococcus agalactia in urine, separated from the vagina, from the skin of a newborn. During the study, the DNA of the pathogen is determined. Latest developments in this area allow the study of virulence genes. The identification of such a genetic composition indicates a high probability of infection of the newborn with a severe form of the disease.

Pregnant women are tested at 35-37 weeks. The PCR method allows you to identify qualitatively and quantitatively streptococcus in the test material. Identification of the number of microorganisms allows you to judge the contamination of the study area. The disadvantage of the method is that it is impossible to identify living representatives of the genus and determine their resistance to antibiotics.

Among inflammatory diseases of bacterial origin that occur during pregnancy, a significant place is occupied by conditions caused by violations of the normal microflora of the genitourinary tract. The microflora of the vagina is characterized by a wide variety of bacterial species and is subdivided into flora characteristic of healthy women(obligate), and pathological. With unfavorable external influences, in stressful situations, with a decrease in the body's immunological defense, with hormonal disorders, gynecological diseases in the genital tract, qualitative and quantitative changes in the microflora can occur. A decrease in the number of bacteria belonging to the normal microflora in the vagina leads to a decrease in protective barriers in the vagina, and to excessive reproduction of opportunistic microorganisms. Violations of the normal microflora of the birth canal pose a great danger to pregnant women, as it can lead to abortion, premature birth, intrauterine infection fetus and postpartum inflammatory complications in puerperas.

Physiological and biological changes that occur in the genital tract during pregnancy lead to the fact that the vaginal microflora becomes more homogeneous with a predominance of lactic acid bacilli (lactobacilli).

There are a number of factors that control and influence the composition of the normal vaginal microflora. The vaginal environment affects the microflora, providing conditions for possible presence in certain quantities various types microorganisms. In general, the vaginal microflora includes different kinds microorganisms. Vaginal discharge normally contains 108-1010 microorganisms per 1 ml, while aerobic bacteria are 105-108, anaerobic 108-109 CFU / ml. Lactobacilli dominate in the microbial flora of the vagina and cervix. It should be noted that bifidobacteria are more common in pregnant women than lactobacilli, and this fact is regarded as a reaction to the absence or inhibition of lactobacilli. In general, anaerobic organisms prevail over aerobic and facultative anaerobic organisms. Among aerobic bacteria, diphtheroids, staphylococci, streptococci are most often detected, and among anaerobic bacteria - lactobacilli, bifidobacteria, peptostreptococci, prevotella and bacteroids.

streptococcal infection

The family of these microorganisms includes several genera of morphologically similar gram-positive cocci, which are facultative anaerobes. There are serological groups of streptococci A, B, C, D, E, F, G and H. appearance colonies and the nature of hemolysis on blood agar, these pathogens are divided into hemolytic, green and non-hemolytic species. Three groups of streptococci can be present in the vagina of healthy women: streptococci of the viridans group (green streptococci), serogroup B streptococci, and serogroup D streptococci (enterococci). The frequency of detection and the number of streptococci belonging to these groups varies significantly and normally does not exceed 104 CFU / ml. During pregnancy, from the point of view of possible infection, mainly pathogens such as Streptococcus pyogenes (group A beta-hemolytic streptococcus) and Streptococcus agalactiae (group B streptococcus, which has become recent times most common cause infections both in newborns, especially preterm infants, and in their mothers).

Diseases caused by Streptococcus pyogenes

About 20% of pregnant women are carriers (nasopharynx, vagina and perianal area). A pregnant woman may experience: tonsillitis, pharyngitis, pyoderma, urinary infection, chorionamnionitis, endometritis, postpartum sepsis. The infection can be transmitted to the child at birth, with subsequent risk of neonatal sepsis increased, especially with prolonged anhydrous interval.

Is a cultural method (on blood agar aerobically and anaerobically).

In the treatment prescribed antibiotics from the group of penicillins and cephalosporins for at least 10 days. In postpartum sepsis, high doses of parenteral benzylpenicillin or ampicillin are prescribed. Newborns with streptococcal infections are also given high doses of benzylpenicillin, ampicillin, or cephalosporins.

Due to the fact that Streptococcus pyogenes is transmitted by contact, prevention is to comply with the rules of asepsis during childbirth.

Diseases caused by Streptococcus agalactiae

This type of streptococcus is part of the vaginal microflora in 20% of pregnant women. When sick, a pregnant woman may experience asymptomatic bacterial colonization of the vagina and perianal area, infection urinary tract, chorionamnionitis, endometritis.

The main diagnostic method is a cultural method. The more intense the infection of the pregnant woman, the more likely the infection of the child. With delivery through the natural birth canal, the frequency of transmission of infection to the child is 50-60%. The risk of disease in a full-term baby is 1-2%, and in a premature baby - 15--20%, with a period of less than 28 weeks of pregnancy - 100%. If a child is infected during childbirth, sepsis, pneumonia, meningitis, and severe neurological complications may develop. In severe cases, the disease begins immediately after birth and progresses rapidly. The risk to the child increases with premature rupture amniotic sac, premature birth, symptoms of chorionamnionitis in the mother.

When prescribing treatment it should be taken into account that group B streptococci are sensitive to all beta-lactam antibiotics, cephalosporins. If streptococci are detected in a pregnant woman, even without clinical symptoms, penicillin therapy is necessary for 10 days, cephalosporins and macrolides may be used.

Prevention. According to some studies, the appointment of ampicillin to a woman in labor prevents infection with Streptococcus agalactiae. The disadvantages of prophylactic administration of ampicillin include the need for a preliminary bacteriological study. It is advisable to screen all pregnant women in the third trimester for the presence of group B streptococci using gynecological culture.

Bacterial vaginosis

Among bacterial diseases large in pregnant women specific gravity constitute pathological conditions associated with violations of the normal microflora of the genital tract. Bacterial vaginosis is clinical syndrome, conditioned pathological change structures of the microbial environment of the vagina. In patients with bacterial vaginosis, to a large extent concentrations of facultative and anaerobic bacteria predominate, which displace lactic acid bacilli, which leads to significant changes in the vaginal microflora. Main Feature violations of the composition of the normal vaginal microflora in bacterial vaginosis is a significant decrease in the number of lactic acid bacilli and a pronounced colonization of the vagina by anaerobic bacteria (Prevotella / Porphyromonas spp., Peptostreptococcus spp., Fusobacteium spp., Mobiluncus spp.) and Gardnerella vaginalis.

During pregnancy, the reasons for the violation of the normal composition of the microflora of the vagina may be the corresponding hormonal changes, use of antibiotics, etc. More than half of all women with bacterial vaginosis have no subjective complaints and no abnormal discharge from the genital tract (leucorrhoea), along with positive laboratory findings. An inflammatory reaction of the vaginal epithelium is not a characteristic feature of bacterial vaginosis. In the clinical course bacterial vaginosis with severe symptoms, prolonged, abundant, liquid, milky or grayish-white homogeneous discharge (leucorrhoea), mainly with an unpleasant fishy odor, is noted.

Bacterial vaginosis occurs in 15 - 20% of pregnant women, and is a serious risk factor for developing infectious complications. A pronounced relationship of bacterial vaginosis with premature termination of pregnancy and untimely rupture of the amniotic membranes was noted. The risk of developing these complications compared with healthy pregnant women in patients with bacterial vaginosis increases by 2.6 times. Approximately 10% of women who give birth prematurely from the amniotic fluid excrete gardnerella and other microorganisms, while normally amniotic fluid sterile. It was noted that in women who gave birth before 37 weeks. available high probability the presence of bacterial vaginosis.

There is also a relationship between the presence of bacterial vaginosis and the development of postpartum endometritis, including after caesarean section. The risk of developing postpartum endometritis in pregnant women with bacterial vaginosis is 10 times higher than in healthy women. The microbial flora detected in the endometrium in patients with endometritis is often similar to that in bacterial vaginosis. This is especially true for anaerobic microorganisms. Mixed microflora in bacterial vaginosis can lead to the development of other inflammatory complications, such as breast abscess, inflammation umbilical wound and etc.

Thus, patients with bacterial vaginosis are included in the group increased risk on the development of inflammatory diseases of the pelvic organs, premature termination of pregnancy, untimely discharge amniotic fluid, the occurrence of chorionamnionitis, postpartum and postoperative endometritis. A high concentration of virulent microorganisms in the vagina of patients suffering from bacterial vaginosis is a risk factor for the penetration of bacteria into higher sections. genitourinary system.

Diagnostics - the complex includes four diagnostic tests

with external gynecological examination patients in the area of the vestibule of the vagina are noted typical for bacterial vaginosis leucorrhoea. If the discharge is too profuse, it may also drain to the perineum. In this case, usually the external genital organs are not hyperemic and not edematous. However, in the presence of concomitant infection, edema and hyperemia of the vaginal mucosa are observed;
PH value of vaginal discharge in patients with bacterial vaginosis is usually 5.0 - 6.0;
a positive amine test, which is accompanied by the appearance of an unpleasant fishy odor when exposed to a 10% potassium hydroxide solution on a sample of the contents from the middle third of the vagina;
detection by microscopy in the discharge from the vagina of "key cells", which are mature cells of the vaginal epithelium with adhered to them in in large numbers microorganisms, which are located mostly randomly.

Microscopic analysis of vaginal secretions is the method of final diagnosis, including Gram-stained smears.

Treatment of bacterial vaginosis

In the first trimester of pregnancy, for the treatment of bacterial vaginosis, it is possible to prescribe clindamycin 2% in the form of a vaginal cream, 5.0 g for 3-7 days, or povidone-iodine, 1 vaginal suppository per day for 14 days, or from the 10th week of Terzhinan, 1 vaginal tablet 10 days.

In the II trimester of pregnancy, the arsenal of drugs for the treatment of bacterial vaginosis can be supplemented with Clotrimazole 1 vaginal tablet for 10 days, as well as the appointment of Clindamycin 300 mg orally 2 times - 7 days.

In the III trimester, in addition to the listed drugs, Ornidazole 500 mg 2 times - 5 days, or Metronidazole 500 mg 2 times - 7 days, as well as Viferon-2 Suppositories or KIP-feron 1 suppository 2 times 10 days rectally can be used.

Gonorrhea

The causative agent of the disease is Neisseria gonorrhoeae- Gram-negative bacteria sensitive to light, cold and dryness. Outside the human body, these pathogens are not able to live long. The infection is transmitted by sexual infection. When infected, gonococci are detected in the urethra, big gland vestibule, cervix, tubes and peritoneum. The infection can spread through the mucous membranes of the endometrium and pelvic organs.

In 80% of women, gonorrhea is asymptomatic, with cervical lesions observed in more than 50% of cases, rectum - more than 85%, pharynx - more than 90%. The presence of gonorrhea in a pregnant woman is significant factor risk of adverse outcomes for both mother and fetus. Women who contract gonorrhea after 20 weeks of pregnancy or after childbirth have an increased risk of developing gonococcal arthritis. In acute gonorrhea, the risk of premature rupture of amniotic fluid is increased, spontaneous abortion and premature birth. Chronic gonorrhea may worsen immediately after childbirth, with an increased risk of gonococcal sepsis.

Infection of the fetus occurs in utero or during childbirth. Intrauterine infection is manifested by gonococcal sepsis in the newborn and chorionamnionitis. Infection during childbirth can lead to gonococcal conjunctivitis, otitis externa, and vulvovaginitis.

If gonorrhea is suspected, a study is made of discharge from the vagina and cervix. An indicative diagnosis is established when pathogens of gonorrhea are detected in a smear. To confirm the diagnosis, sowing of the discharge on a special medium is used. Also use the PCR method.

Treatment of gonorrhea in pregnant women

Treatment of pregnant women at any gestational age should be carried out in a hospital. Treatment of disseminated gonorrhea should be carried out with the involvement of specialists of the appropriate profile. In the treatment of the disease, pregnant women with gonococcal urethritis, endocervicitis, proctitis or pharyngitis are prescribed ceftriaxone 250 mg intramuscularly or spectinomycin (trobicin) 2.0 g intramuscularly once. With gonococcal sepsis, ceftriaxone is prescribed 1 g intravenously or intramuscularly 1 time per day for 7-10 days. 7 days after the end of treatment, repeated crops are carried out. With ophthalmic rhea of newborns, ceftriaxone is used at a dose of 25-50 mg / kg intravenously or intramuscularly once and frequent washing of the conjunctiva with isotonic sodium chloride solution.

As a control for treatment, sowing is carried out after the end of treatment after 7 days and after 4 weeks.

As a preventive measure during the initial examination of a pregnant woman, it is necessary to sow the discharge from the cervix for gonorrhea. Women at risk at the end III trimester pregnancy is prescribed repeated crops. Treatment of sexual partners.

The most common pathogens during childbearing are group A streptococcal infections (Streptococcus pyogenes) and B streptococci (Streptococcus agalactiae). To date, group A streptococcus, which is present in the microflora of the vagina, has become a common cause of infection in newborns and pregnant women.

Group A streptococcal infection during pregnancy

The causative agent is Streptococcus pyogenes (beta hemolytic).
Risk - 20% of women during pregnancy are carriers (nasopharynx, vagina and perianal area).
Clinic - tonsillitis, pharyngitis, pyoderma, colonization of the vagina and perianal area, chorionamnionitis, endometritis, postpartum sepsis.
Streptococcal infection during pregnancy is diagnosed by the cultural method (aerobically and anaerobically on blood agar).
Impact on the fetus - intranatal transmission, the risk of neonatal sepsis increases with a long anhydrous interval.
Prevention during pregnancy - identification of risk factors, compliance with the rules of asepsis in childbirth, antibiotic therapy based on the results of gynecological culture.
Treatment of streptococcal infection - penicillins, cephalosporins for at least 10 days.

Streptococci A cause respiratory diseases (pharyngitis, scarlet fever), skin and wound diseases, sepsis, acute wound fever, glomerulonephritis.

At the heart of diseases, which are complications caused by these streptococci, are autoimmune mechanisms, possibly a healthy carriage.

From point of view perinatal diseases it is necessary to take into account the possibility of vertical transmission of streptococcal infection from mother to newborn, the source of transmission may be the intestines and vagina. Despite the use of antiseptics and antibiotics during pregnancy, an increase in the number of most serious illnesses caused by group A streptococcal infection, including severe neonatal sepsis.

Diagnostics

Diagnosis of streptococcal infections involves culturing the test material on blood agar under both aerobic and anaerobic conditions.

Treatment

If a streptococcal infection is detected during pregnancy, then penicillin therapy is necessary for 10 days, the use of cephalosporins and macrolides is possible. In postpartum sepsis, high doses of parenteral benzylpenicillin or ampicillin are prescribed for treatment. Newborns diagnosed with streptococcal infection are also given high doses of benzylpenicillin, ampicillin, or cephalosporins.

Streptococcus pyogenes is transmitted by contact. Prevention consists in observing the rules of asepsis during childbirth.

Group B streptococcal infection during pregnancy

The causative agent is Streptococcus agalactiae.
Risk in pregnant women - is part of the vaginal microflora in 20% of pregnant women.
Prevalence - The incidence of neonatal sepsis due to group B streptococcus in the United States is 2 per 1,000 live births.
Clinic - asymptomatic bacterial colonization of the vagina and perianal region, chorionamnionitis, endometritis.
Streptococcal infection is diagnosed by culture.
How does streptococcal infection during pregnancy affect the fetus? In 80%, infection during childbirth is sepsis; in 20% - meningitis, severe neurological complications.
Prevention of streptococcal infection - identification of risk factors, antibiotic therapy based on the results of gynecological culture.
Treatment during pregnancy - penicillins, cephalosporins, macrolides.

signs

Early signs of streptococcal infection during pregnancy are respiratory disorders and impaired microcirculation in the skin, as well as tachycardia. Consumption coagulopathy with petechiae and skin bleeding is late symptom. Mortality in the fulminant course of the disease is very high. Later forms occur mainly in the form of meningitis. Mortality due to cerebral edema is about 25%. In therapy, cephalosporins and macrolides are more often used.

In an "early attack" in a newborn, the source of these bacteria is always the mother's rectovaginal flora. "Late attack" may be the result of nosocomial infection. With adequate monitoring of pregnant women and newborns and timely treatment of "early attack", a decrease in mortality to zero is observed. The prognosis for a "late attack" of meningitis is incomparably worse. long-term consequences are movement disorders cerebral origin, hydrocephalus and retention mental development. The risk for the child increases with premature rupture of the membranes, premature birth, symptoms of chorionamnionitis in the mother.

Diagnostics

The diagnosis of perinatal streptococcal infection during pregnancy is confirmed by the detection of Streptococcus agalactiae in blood cultures, cerebrospinal fluid, or urine. Identification of these pathogens in samples from the skin and mucous membranes, from meconium primarily indicates only colonization. It is reasonable to screen all women in the third trimester for group B streptococci by gynecological culture.

Treatment

Group B streptococci are sensitive to all beta-lactam antibiotics, cephalosporins. If a streptococcal infection is detected in a pregnant woman even without clinical symptoms, penicillin therapy is necessary for 10 days, cephalosporins and macrolides may be used.

Antibiotic prophylaxis with ampicillin at a dose of 2 g 3 times a day significantly reduces the incidence of the disease in children. In postpartum sepsis, high doses of parenteral benzylpenicillin or ampicillin are prescribed. Newborns with streptococcal infections are also prescribed high doses of benzylpenicillin or ampicillin, cephalosporins.

According to some studies, the appointment of ampicillin to a woman in labor prevents infection with Streptococcus agalactiae. The disadvantages of prophylactic administration of ampicillin include the need for preliminary bacteriological examination and allergic reactions for the drug.

Infectious diseases of the urinary system are diagnosed in expectant mothers by urine culture. Quite often, during bacteriological examination, streptococcus is found in the urine during pregnancy, which is activated due to hormonal adjustment and reduced immunity.

The danger of infection is that in most cases it is asymptomatic, and can cause pathologies of the placenta and infection of the baby.

More than 18 hours passed after the discharge of amniotic fluid and before the birth of the child.
At the time of delivery, the woman had a body temperature of more than 37.5 degrees.
The age of the woman in labor is up to 20 years.
Childbirth up to 37 weeks.

It should be noted that Streptococcus agalactia is common cause of death in newborns. As a rule, signs of infection appear immediately after birth. Children have pale skin, uneven breathing, elevated temperature, vomiting and neurological pathologies.

Despite the fact that the risk of infection of babies is quite low, about 2 cases per 100 infected women in labor, It is not worth refusing to diagnose for streptococci.

Urine test for streptococci

One of the most informative tests for streptococcus infection is bacteriological culture urine

One of the most informative tests for infections internal organs is bacteriological culture of urine. This study carried out when registering for pregnancy, and in the third trimester.

Using the results of the analysis, it is possible to determine the presence of an infection that can be transmitted in utero, or infect a child at birth. In order for the result to be as accurate as possible, the following rules must be observed:

Stop taking diuretics and choleretic drugs 3 days before the test.
For a day, exclude heavy, salty and smoked foods from the menu.
Collect only the mid-morning urine in a sterile container.
Before collecting the analysis, it is necessary to carry out hygiene of the genital organs, and insert a cotton swab into the vagina.
You need to pass the analysis within two hours after collection.

Streptococcus agalactia in the urine during pregnancy is determined by sowing the material on a nutrient medium - a solution of 5% blood agar. In order for the bacterium to grow, it is provided with an optimal temperature for development of 37 degrees.

If streptococci are present, they form grayish plaque colonies that are examined under a microscope. Next, the bacteria are sent to test tubes, to determine the characteristics and sensitivity to antibiotics.

On average, a urine test for streptococci is prepared for 7 days. The advantage of the study is its high accuracy, the exclusion of erroneous results and false reactions.

What is dangerous streptococcus agalactia during pregnancy

In women, this type of streptococcus often causes an infectious lesion of the genitourinary system. Inflammatory processes occur due to a decrease in immunity and the reproduction of a large colony of streptococcus.

Urogenital diseases can be recognized by signs such as pain in the lower abdomen, itching, fever, copious discharge from the vagina.

Streptococcus agalactia during pregnancy often causes an infectious lesion of the genitourinary system

Often streptococcus causes the following diseases:

Urethritis- this is inflammatory process mucous membrane of the urethra. In the absence of adequate treatment, urethritis leads to cystitis and inflammation of the appendages.
cervicitis- Infectious inflammation of the cervix. A complication of the disease can be cervical erosion, dysplasia and cancer.
endometritis- inflammation of the uterine mucosa is the most dangerous disease, because it can be accompanied uterine bleeding, placental insufficiency and throw out.

With a large number of streptococcus colonies, inflammation of the membranes is possible, which invariably leads to premature birth, pathology of fetal development, and a violation of the course of pregnancy. If a pregnant woman has not undergone medical treatment before the birth of a child, there is a risk of infection of the baby during childbirth.

As a rule, weakened and premature babies with pathologies are at risk.

Streptococcus agalactia during pregnancy can cause dangerous infectious diseases in infants immediately after birth or a few days later.

streptoderma - affects the upper layers of the skin, and can cause deep erosions. You can recognize the infection by flat vesicles with transparent, and then purulent contents. The pustule is accompanied severe itching which brings anxiety to the baby.

Ecthyma vulgaris - deep skin lesions with ulcers. Purulent vesicles with yellow crusts form on the skin, under which a painful ulcer occurs. Baby's body temperature is elevated general state lethargic, sleepy. Complications can be lymphadenitis and lymphangitis.

Streptococcus agalactia during pregnancy can cause serious infectious diseases in infants immediately after birth

Sepsis – dangerous development streptococcal infection, which can be fatal. Symptoms of the disease are persistent fever, fever. If left untreated, toxic shock develops with damage to internal organs.

Meningitis - the inflammatory process of the membranes of the brain is manifested by pallor skin, fever, skin rash. A complication can be toxic shock, developmental delay.

Pneumonia - develops as a result of damage to the alveoli of the lungs. Characteristic signs: shortness of breath, cough, vomiting, refusal of food. The infection has a severe course, but with timely drug treatment favorable outcome increases significantly.

Necrotizing fasciitis Streptococci infect connective tissues and organs. characteristic feature diseases are numerous ulcers and purulent wounds. Diagnosis of the disease in children is extremely rare.

Any disease caused by streptococcal infection has a severe course and poses a great threat to the life of the baby. Only when timely treatment and proper medical care, the newborn has a chance to survive.

But unfortunately, not every child recovers completely, many of them have pathologies and suffer from CNS disorders.

If a woman has been found streptococcus in the urine during pregnancy, treatment should begin As soon as possible especially if the infection is diagnosed after 30 weeks. For therapy, penicillin or ampicillin is used.

These drugs are absolutely safe for future mother and baby, and don't cause any adverse reactions. Before starting treatment with a penicillin-based antibiotic, it is necessary to test for an allergic reaction.

Ampicillin

The human body is regularly exposed to various bacterial infections that need to be diagnosed and treated in a timely manner. Special attention to own health expectant mothers must show more at the planning stage of pregnancy, as they put at great risk not only their health, but also the life of the unborn child.

In order to avoid infection with streptococcus, it is necessary to provide regular hygiene genital organs, strengthen the immune system, timely treat diseases of the urinary system and listen to the recommendations of the supervising gynecologist.

In contact with

Streptococcal infection during pregnancy in a smear is detected quite often. In some regions, this figure is significantly higher than the average of 30%. This is explained by the transmission of the disease. Streptococcus isolated in smears of a pregnant woman could enter the body of a woman through one of the following ways:

From person to person, for example, when shaking hands, kissing.
Sexually.
The use of personal hygiene items by several people, one of whom is a carrier of a bacterial infection. This applies not only to towels, but even soap.

During the gestation of the fetus in women, immunity is significantly reduced. This is due to certain changes in the body.

Infection can occur both at the beginning of pregnancy and during recent weeks. Therefore, significant attention should be paid to the safety of the future woman in labor. In some cases, it is even useful to limit the circle of contacts.

At risk are women who have addictions that further inhibit the functioning of the immune system. Also, negative consequences are more often recorded in those who suffer from diabetes.

In addition to the unsystematic course in a latent form, the detected streptococcus in the urine of a pregnant woman can lead to the development of various skin rashes. We are talking about the following diseases:

Superficial streptoderma. They come in the following varieties - Tilbury Fox, folds, annular, periungual, slit-like, bullous, lips, mucous membranes, including oral cavity and throat.
Deep streptoderma have one form. The disease is called ecthyma.
Atypical streptoderma is a simple lichen, acute diffuse streptoderma. Papular syphilitic impetigo occurs only in children of 1 year of age in the absence of proper hygiene care. Its second name is diaper dermatitis.

Often, pregnant women confuse the first manifestations of a streptococcal infection with other ailments. Therefore, it is important to know what symptoms are characteristic of this disease.

Symptoms and signs of streptococcal infection in pregnant women

Streptococcus in the urine of a pregnant woman - enough frequent occurrence. In most cases, it is sufficient to carry out drug therapy with antibiotics to get rid of a bacterial infection. The situation is much worse when group b streptococcus is detected in pregnant women. The influence of this strain can lead to the death of the mother after childbirth, their premature onset, infection of the child.

Doctors allocate the following symptoms, which are characteristic of a clear manifestation of streptococcal infections:

A - skin rashes in the form of streptoderma, respiratory tract lesions, reproductive system, urinary tract.
B - can cause early meningitis, pneumonia, endocartitis, septic arthritis in a newborn.
C and G are the causative agents of zoonotic diseases.
D - as well as A manifests itself in the form of streptoderma.

With a significant decrease in immunity, moderate growth of streptococcus during pregnancy can lead to the development of various serious diseases.

The infection may be localized to gastrointestinal tract, respiratory tract, genitals and reproductive organs. In severe cases, the circulatory and lymphatic systems are affected, which leads to damage to the joints, heart, and brain.

Treatment of streptococcal infection during pregnancy

The methodology for influencing streptococcal infection, the choice of drugs, largely depends on the manifestation of the disease. In addition to eliminating the pathogen itself, a course of immunomodulatory therapy is recommended. You can use such as rosehip broth, pomegranate juice, tea with chamomile and lemon balm.

Streptococcus in the throat in pregnant women is quite common. In this case, appoint Amoxicillin, Azithromycin, Cefuroxime. With a high frequency, streptococcal infection manifests itself in the form of seizures in the corners of the lips. Antibiotic ointments are used for treatment. Also, the skin around the lesion should be wiped with a solution of chloramphenicol, boric or salicylic acid.

Streptococcus in cervical canal during pregnancy, it is necessary to eliminate in without fail. In this case, there is high risk infant infection during childbirth. Medical therapy assigned individually. It is advisable to immediately use the latest generation of antibiotics.

Consequences of streptococcal infection for mother and fetus

If streptococcus is detected during pregnancy in bakposev, it is necessary to undergo a course of antibiotic treatment prescribed by a doctor. The importance of this is determined by the fact that there is a probability of up to 2%. Approximately 15% of infected babies die. To avoid lethal outcome timely prescribed drug therapy will help.

Infection of an infant with epidemic pemphigus, which is caused not only Staphylococcus aureus, on and some streptococci, is not the fault of the staff of maternity hospitals. Often, its cause is a young mother who refused to take "unnecessary" tests.

Beta hemolytic streptococcus in pregnant women occurs in about 4% of the total number of women. In the normal state of the body, its presence does not manifest itself in any way. The situation is completely different when carrying a fetus. Especially if a pregnant woman has streptococcus agalatikps 10 6 degrees. Often, obstetricians associate the onset of premature birth with its presence.

Alevtina Aasar, therapist, specially for the site