Igg in pregnancy

In a state of pregnancy, the body of a woman is prone to weakening the immune system. In this regard, there may be diseases that previously did not make themselves felt. In addition, infection with various infectious diseases is likely against a background of reduced immunity. IgG in pregnancy It is known that any illnesses during the period of gestation can negatively affect not only the woman, but also the future child. A special danger for pregnant women is cytomegalovirus. This pathogen is capable of causing various fetal lesions and its death, so all women in the position and planning pregnancy are assigned an analysis for the detection of IgG antibodies.

What is cytomegalovirus and what are the ways of infection?

The causative agent of cytomegalovirus infection (CMVI) is referred to as viral herpetic microorganisms. Often they are found in people with immunodeficiency or in pregnant women. The danger of the virus consists in complications and severe consequences of its vital activity in the body. Cytomegalovirus is diagnosed in many people, most of them do not even know that they are his carrier, like other herpes viruses, he can not give himself away. The consequences of the disease appear only in people with weakened immunity. Such a risk group includes pregnant women. Another name for the disease is cytomegaly, indicating an increase in the size of the affected cells. Once in them, the virus destroys the internal contents, the cells swell as a result of filling with liquid. cytomegalovirus route of infection If the infection occurred long before pregnancy, then the virus is not dangerous. In the body, it is in a latent state and does not harm the future child. Only 1-2% of pregnant women are infected with the fetus. Therefore, the decisive role in the pathogenic action of the causative agent of CVI is played by the infection time. The most dangerous is considered to be infection in the first trimester of pregnancy. The causative agent can enter through the placental barrier, penetrate into the fetus and cause its death. If you become infected later, pregnancy does not stop on your own, but such children have high chances of congenital malformations and serious illnesses. In the period of gestation, cytomegalovirus can be infected in various ways. The main way of infection of adults is sexual contact. Occasionally, cases of infection by airborne droplets and general use of hygiene items at home are recorded. There were also cases of infection with blood transfusion, tissue transplantation, organs and the use of donor material (eggs and spermatozoa) for artificial insemination. There is a possibility of intrauterine transmission of infection from the mother to the baby, as well as breastfeeding. In pregnant women, the development of CMVI causes symptoms resembling an acute respiratory viral disease, but the main difference is the duration of the disease. With cytomegalovirus infection, these symptoms can be observed 4-6 weeks. Against the background of immunodeficiency, such severe complications as pneumonia, encephalitis, myocarditis, arthritis and pleurisy develop. Generalized forms of the disease are very rare and can lead to death.

Diagnosis of cytomegalovirus in pregnancy

Research on cytomegalovirus during pregnancy is a mandatory procedure for all expectant mothers. Samples of saliva, urine or serum are used for laboratory diagnosis. There are several methods for determining the pathogen:
  • serological examination of serum for the detection of antibodies specific for cytomegalovirus (IgG, IgM);
  • cytological examination of urine sediment or saliva for the determination of enlarged cells;
  • the polymerase chain reaction (PCR) method is based on the detection of the DNA of the virus.
At the moment, the most accurate is the serological method. The presence of antibodies in the serum indicates the presence of immunoglobulins specific for cytomegalovirus. They effectively and quickly destroy viral particles. Such immunoglobulins come in several varieties:
  1. Class M (IgM) - produced immediately after infection, relatively large, there are short-lived, but quickly suppress the reproduction of the virus. Thus, they provide a recovery or an asymptomatic course of the disease.
  2. Class G (IgG) - come in the stead of IgM, smaller in size, but are constantly produced by the body, which ensures its protection from a viral infection.
cytomegalovirus diagnosis It should be noted that IgG and IgM suppress only those viral particles that are outside the cells. The causative agent that enters the neurons and cells of the immune system remains there throughout life and constantly produces a certain amount of viral particles into the total bloodstream, where they are suppressed by IgG immunoglobulins. Weakened immunity leads to a decrease in the number of these antibodies, and viral particles can almost freely infect nearby cells. Mass re-duplication of the virus in the body leads to a relapse of the disease. With many serological studies, the concept of avidity of IgG antibodies is used to determine the "limitation period" of a viral infection in the body. The index of avidity can have the following indicators:
  • below 50% - primary infection less than three months ago;
  • 50-60% - the result is not determined, repeated examination is appointed;
  • more than 60% - the body is the carrier of the virus and actively suppresses its development;
  • 0 - negative result, there was no infection.
In a healthy person with a normal immune system, a positive test result for antibodies to cytomegalovirus should not cause concern. The body's defenses can provide an asymptomatic course of the disease.

Interpretation of the antibody test for a pregnant woman

Determination of IgG antibodies in the blood of a pregnant woman is not a verdict, but indicates that her body had previously encountered a virus and, under normal immunity, is reliably protected from its negative effects. About 90% of the population are hidden carriers of cytomegalovirus, so this result is more likely a norm, not a pathology. In the vast majority of people, infection occurs even in childhood.
Positive IgG is a rather good indicator for planning and pregnant women, since the risk of fetal damage is 0.1%, while during the first infection of a woman in the first months of pregnancy this indicator increases to 9%. Positive IgM in the blood is just a testament to the recent infection.
To accurately interpret the results, several indicators are examined simultaneously, according to which the study was conducted.

The results of the CMV study, taking into account the risk to the fetus

IgМ IgG IgG avidity Diagnosis Probability of congenital form of CMVI in fetus
+ - - primary recent infection high
+ + low primary recent infection high
+ + high exacerbation of latent infection low
- + (increase in titer in the subsequent examination) high exacerbation of latent infection low
- + (no changes in titer in the subsequent examination) high latent long-standing infection (latent) practically absent
- - - In the past there is no contact with the virus or the period of the "serological window" * a second examination is recommended 2-3 weeks later **
Notes: * "Serological window" refers to the period between infection and the appearance of antibodies in a woman's blood; ** The survey should be conducted in the same laboratory using the same equipment as in the first analysis. In women, carriers of HIV infection, the level of antibodies is very low and is not determined in the blood. For diagnosis, other biological media are used by PCR. If IgM and IgG are detected in the bloodstream of the clinical manifestations of CVI, it is necessary to seek the appointment of a course of treatment. In the event that against the background of a mononucleoside-like syndrome, antibodies of both classes are absent in the analysis, a re-examination is performed after 2-3 weeks. Pregnant women should follow the following procedure with different results of analyzes on CVM:
IgМ IgG Actions
+ + (low-viscous) Examination of an infectious disease specialist to determine the probability of infection of the fetus.
+ -
- + (low-viscous)
- - Repeated examination after 2-3 weeks to exclude the "serological window". If the result is negative again, the test is administered after 4-8 weeks.
- + (lofty) Treatment is not required. It is possible to re-examine the blood after 1-2 months to exclude exacerbation of a chronic infection.
It is difficult to interpret the analysis done once after the fifth week of pregnancy. Primary infection could occur immediately after fertilization and by this time antibodies IgG have already been developed.

Treatment CMVI appoint only as a last resort. The drugs have a serious side effect, so they are used only with clear indications and prescribed by the doctor with observance of the prescribed terms and dosages. If the tests showed no IgM and IgG antibodies, the pregnant woman should follow precautionary measures to prevent infection during this period. Small children are often the source of this virus, so it is better to limit contact with them. In addition, it is required to follow the rules of hygiene, not to use someone else's dishes and avoid people who suffer from cold and viral infections.