Insidious infections

Insidious Infections 6

Health of pregnant women

Insidious Infections

What are dangerous for pregnant women, sexually transmitted diseases

Igor Baranov Leading researcher of the department of management of pregnant women with high infectious risk of the Scientific Center of Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences, MD.

WHAT THE DANGER IS POSSIBLE

Both at the stage of preparation for pregnancy, and after its onset, doctors pay great attention to the diagnosis, prevention and treatment of various infections. And in the first case, both partners are examined, and in the second case, only a woman is examined. Why is it so important? Because the infectious process often leads to a deterioration in reproductive health, infertility (both male and female), and during pregnancy can adversely affect the course of pregnancy (in this case, it is typically prematurely interrupted). Viral or bacterial infection, especially in the first trimester of pregnancy, can cause significant damage to the child: cause intrauterine infection, malformations, disrupt the development of organs and systems. In pregnant women, viral infections most often occur secretly, without causing any particular harm, but nevertheless, the penetration of viruses through the placental barrier is possible; most often children become infected during childbirth. Optimal, if the survey partners are carried out in advance, before the onset of pregnancy. Do not think that if there are no signs of trouble (for example, secretions from the genital tract, itching in this area), then there are no infections. For the time being, many diseases can be completely asymptomatic. So, we list the most common infections, which can have the most severe consequences:

  • herpes simplex virus, 
  • цитомегаловирус (Cytomegalovirus),
  • chlamydia (Chlamydia), 
  • уреаплазма (Ureaplasma man) 
  • Mycoplasma (Micoplasma),
  • trichomonas (Trichomonas vaginalis),
  • yeast-like candida fungus (Candida albicans),
  • gonococcal,
  • syphilis,
  • HIV infection,
  • hepatitis B and C viruses.

Most often, inflammatory processes cause the herpes simplex virus, cytomegalovirus, chlamydia, ureaplasma, mycoplasma, candida; The percentage of infection with these pathogens is very high. For example, the overwhelming majority of adults are infected with the herpes simplex virus.

DIAGNOSTICS

If the couple plans a pregnancy, it is advisable to carry out the diagnosis both to the woman and her partner. During pregnancy, diagnosis is performed only by a woman, and in case of detection of infections - to her partner. A smear on the flora from the cervix in women or from the urethra canal in men can reveal candidiasis, trichomoniasis, gonorrhea. This is a bacterioscopic method (a smear is applied to a slide, colored and studied with a microscope). The method of polymerase chain reaction (PCR) allows to determine the presence of chlamydia, mycoplasma, ureaplasma, herpes simplex virus and cytomegalovirus. This is a qualitative reaction that identifies fragments of the pathogen in the test material (smear, plasma, etc.). The way the organism coexists with the pathogens of infections, allows to find out the enzyme immunoassay (ELISA), during which the presence and correlation of immunoglobulins M and G is clarified. This method shows whether there is an infection and whether it is active. An in-depth examination is carried out by those who have had problems with a previous pregnancy or, for example, when a pregnant woman contacts a sick rubella. This is not a sexual infection, but if the pregnant woman suffered it in the first trimester, it is usually decided to terminate the pregnancy.

Before the onset of pregnancy, men take the same tests as women (most often a scraping from the urethra for the detection of infections by PCR). In addition, all pregnant women take blood tests for HIV, syphilis (Wasserman reaction - RW), hepatitis B and C. In our country, these tests are taken from all pregnant women without exception. When identifying these infections, a woman must necessarily be examined and a man.

A little more detail on vaginal candidiasis - one of the most common infections during pregnancy. Candidiasis causes the microscopic fungus Candida albicans. In the vagina of a healthy woman live and useful microbes (lactobacilli), and microorganisms that, under certain conditions, can become pathogenic. The second group includes this yeast-like fungus, which naturally lives in the genital tract, in the intestines, in the mouth, on the skin. If the human immune system functions normally, then pathological growth of the fungus does not occur. During pregnancy, all women experience a natural decrease in immunity, the vaginal microflora changes and vaginal candidiasis may develop. Candidiasis is detected with the help of a smear from the genital tract. In addition, a woman can pay attention to the increase in secretions from the genital tract, change in their nature (with candidiasis discharge have the appearance of curdled crumbs). Whether it is necessary to treat a candidiasis? Of course, you need, like any infection, because if it is present in the lower parts of the genital tract, into the vagina, then the contents of the uterine cavity can become infected, i.e. a fetal egg; a child may become infected during delivery. If a woman has candidiasis, it is necessary to be treated and her partner.

TREATMENT OF INFECTIONS DURING PREGNANCY

If a woman's body is infected, but the infection is not active, doctors can simply observe without interfering with the situation, and if she is active, treatment is required. Any active infection should be treated, another thing is that there is not always such an opportunity. Obviously, it is much better to undergo a course of treatment before pregnancy: in fact in this case the choice of preparations is much more diverse. And if the infection is diagnosed during pregnancy, the hands are in many ways related to the physicians - they should choose the drug very carefully, especially in the first trimester, because during this period the baby's organs are laid. In the third trimester, after 28 weeks, the choice is somewhat extended. Therefore, it is better for parents and safer for the child if the woman comes to treatment in advance - 2 months before the planned pregnancy. If these infections are identified, treatment should be given to both partners. To do this, antiviral, antibacterial drugs, as well as immunity-stimulating drugs are used. In conclusion - a few words about the possibility of sexual contact, if any of the partners have an active inflammatory process. Pregnant women with obvious signs of inflammation of the sexual organs are not allowed to have sex, which is connected with the possibility of further spreading and strengthening the process. If the inflammatory process is active only in the husband or if the couple is being treated, then the sexual life is possible only with the use of a condom. Renewal of a sexual life without a condom is possible after a follow-up study at the end of the course of treatment.

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