If a child is born with infections. Intrauterine infection during pregnancy: how it manifests itself and why it is dangerous

two to three times determination of HIV antigen in the blood using PCR in the first 4 months of life. Until HIV infection is excluded, all children in the first month of life are prevented from severe Pneumocystis pneumonia in newborns with trimethoprim/sulfamethoxazole orally daily or
once a week. Conventional immunization with DTP, polio vaccine, Haetorrhoid virus type B vaccine and meningococcal vaccine is carried out according to the usual schedule. Some pediatricians recommend replacing the live polio vaccine with an inactivated one in order to eliminate the risk of infection of a mother with HIV infection with vaccine viruses, although this is small. BCG vaccination is postponed until HIV infection has been ruled out in the child.
Although HIV infection acquired through vertical transmission can remain asymptomatic for up to 10-12 years, in 20% of cases it manifests itself already in the first year of life with recurrent candidiasis of the oral mucosa, skin rashes, enlarged lymph nodes, hepatosplenomegaly, delayed physical and psychomotor development, pneumonia . Treatment with zidovudine is necessary only when the concentration of the virus is high and the content of CEM lymphocytes in the blood is low. Early diagnosis and treatment significantly increase the life expectancy of patients, but a cure for HIV infection has not yet been achieved. Families of people with HIV infection, even those in which the children are healthy, need constant support and assistance medical workers knowledgeable about the problems associated with this infection.
Diaper dermatitis
So-called diaper dermatitis usually represents skin irritation from ammonia, seborrheic dermatitis or perianal excoriation.
Ammonia is formed when urea is decomposed by intestinal bacteria. The dermatitis caused by it is manifested by erythema, papular rashes, peeling and erosions in places where the urine-soaked diaper comes into contact with the skin. The skin in the depths of the folds, the foreskin and the scrotum are especially often affected. Treatment consists of changing diapers after each urination and bowel movement and using local air baths. With each change of brine, a cream with zinc oxide is applied to the affected areas, and in stubborn cases, silicone cream is applied. Some authors believe that diaper dermatitis is not associated with ammonia exposure. Diaper dermatitis, which cannot be cured within 10 days, is usually skin candidiasis. The latter is characterized by bright erythema with peeling at the edges. Often outside it there are sparse, fresh papular rashes. For candidal diaper dermatitis, nystatin cream should be applied to the affected areas at each diaper change for at least 1 week. The oral mucosa should be carefully examined. If there are white plaques on it (thrush), a nystatin suspension is prescribed orally. Often in such cases, the mother is found to have nipple dermatitis with peeling of candidal etiology, as a result of which the child becomes reinfected. A child with diaper dermatitis should be examined completely undressed, as the rash may also appear on other areas of the skin. With seborrheic dermatitis, erythema and peeling
found in the armpits, on the neck, behind the ears, on the forehead, on the eyelids. The scalp is covered with crusts that are difficult to remove (the so-called seborrheic cap). Seborrheic dermatitis is often complicated by a secondary bacterial infection, staphylococcal or streptococcal, or candidiasis. Seborrheic dermatitis usually begins before 3 months and completely disappears by 9 months even without treatment. Unlike skin irritation from ammonia, seborrheic dermatitis does not cause concern in children. The cause has not been established. There is usually no hereditary burden of dermatitis. 1% hydrocortisone cream is effective, under the influence of which the manifestations of seborrheic dermatitis are eliminated within a few weeks. 9-15- Perianal excoriations are scratched completely.4 In persistent cases, nystatin or topical antibacterial agents are added to treatment. “Seborrheic cap” is removed using 0.5% salicylic shampoo. Perianal dermatitis is often associated with diarrhea. Perianal excoriations that occur with gastroenteritis disappear after stool normalization. Zinc oxide cream and air baths speed up healing, but it mainly depends on normalizing the pH and consistency of stool.

Intrauterine infection in newborns is a serious medical pathology. In some cases, it can be fatal or lead to disability of the child. Most often, viruses are the culprits. Common causes of intrauterine infections in newborns are rubella, toxoplasmosis, parvovirus, etc.

The most dangerous situation is when the mother is infected with a virus after conception or shortly before it. Some infections occur with invisible symptoms, and therefore it is necessary to undergo a series of tests when planning a child, before pregnancy. Among them are those that show the content of M and G antibodies in the blood. Based on the composition of these antibodies, if they are detected, as well as their quantity, the doctor will be able to conclude whether the woman has a primary infection or a relapse. And using this data, calculate the risks for the unborn child, who has not yet been conceived. Sometimes treatment is required or you just need to wait a little before conceiving so that the baby is born healthy.

So, when it occurs for the first time in life, it almost always causes complications for the child. And the sooner it becomes infected, the worse the prognosis. Thus, in the first trimester, the embryo develops numerous developmental defects. Often, as a result of this, the body “gets rid” of the non-viable fetus, and a spontaneous miscarriage occurs. Recurrence of genital herpes rarely leads to infection of the child through the placenta, through the blood, more often this occurs by contact during natural birth. Then the consequences of intrauterine infection in newborns are manifested by a typical rash, damage to the mucous membranes, severe fever, neurological disorders, respiratory failure, eye diseases, etc.

In the first case, intrauterine infection of the fetus, more precisely, its indirect signs, can be detected by ultrasound, such as low weight, premature ripening of the placenta, polyhydramnios or oligohydramnios, amniotic bands, low motor activity, etc. If infection occurs during childbirth, symptoms of the disease appear in the first days after birth. The child is born seemingly healthy. There are no symptoms of intrauterine infection in a newborn baby. But soon lethargy, breathing and reflex problems, neurological problems, poor appetite and sleep, and regurgitation appear. Much of the above can be noticed by the mother herself; more specific signs can be noticed by a neonatologist who examines children daily in the maternity hospital.

Also dangerous. But many newborns who become infected with it before birth are asymptomatic. Only 20% of children have clear clinical manifestations.

Treatment in newborns depends on the type of pathogen (pathogen) and symptoms. These can be antibiotics (antibacterial agents), drugs to support the immune system, antiviral and restorative drugs. Plus, symptomatic therapy is carried out, designed to immediately improve the child’s well-being and support his life.

Today, the lion's share of pathologies in newborns is caused by intrauterine infection. But the most deplorable thing is that such infection very often leads to serious problems with the child’s health, and even to disability or the death of the baby. Timely treatment can help avoid serious consequences.

Often, a mother who leads a healthy lifestyle and avoids any harmful influences gives birth to a child with serious pathologies. Why? Doctors explain this by low immunity - under any circumstances it decreases during gestation. Against the backdrop of poor reactivity of the body, hidden infectious diseases. More often, such a picture is observed in women in the first three months of pregnancy.

What exactly can threaten a newborn baby? Today, the most dangerous viruses for the fetus are:

1. Rubella.
2. Cytomegalovirus.
3. Hepatitis B.
4. Chicken pox.
5. Herpes.
6. Bacteria that cause syphilis, tuberculosis, listeriosis.

An extremely dangerous representative of the protozoan kingdom is Toxoplasma.

Let's take a closer look at each of them and the consequences of intrauterine infection in newborns.

Rubella

As for this virus, it rarely causes serious pathologies in an adult, but for an unformed baby in the womb it is very dangerous. The greatest risk for the baby is when infected before 4 months.

An expectant mother can become infected with this virus through airborne droplets. If the fetus becomes infected, the child may develop complications:

• Eye damage.
• Underdevelopment of the brain.
• Meningitis (that is, inflammation of the membranes of the brain).
• Pathologies of the cardiovascular system.
• Congenital deafness.
• Enlarged liver.
• Intradermal hemorrhages.
• Enlarged spleen.
• Pneumonia.
• Stillbirth.
• Miscarriage.

It is impossible to cure a child while he is in the womb. Therefore, it is worth checking your immunity for the presence of antibodies to this virus at the preparatory stage for pregnancy and during it.

If the mother does not have immunity to rubella, then it is worth getting vaccinated when planning to conceive a child.

Cytomegalovirus

The main route of transmission of CMV is sexual. There is also the possibility of infection through saliva and blood. This virus migrates to the child only through the placenta. And it is very dangerous for the fetus if infected in the last months of pregnancy.

Possible pathologies due to intrauterine CMV infection:

• Hearing loss or absence.
• Hydrocephalus (excess fluid that puts pressure on the brain) and microcephaly.
• Increased size of the liver and spleen.
• Pneumonia.
• Blindness.
• Stillbirth.
• Miscarriage.

The consequences of intrauterine infection in newborns depend on the degree of infection: in case of severe infection, the prognosis is unfavorable - for 30% of children, death occurs in the first year of life. If severe infection was avoided, then there is a high probability of giving birth to a completely healthy child.

Human immunodeficiency virus

Today, doctors have achieved that an HIV-infected mother can give birth to a completely healthy baby. However, there is a risk of fetal infection.

Children with congenital HIV infection have very weak immunity, and without proper therapy they do not live to see a year. It is not HIV itself that kills them, but concomitant infections. Therefore, it is very important to identify the disease in a pregnant woman in time and begin therapy.

Hepatitis B

The virus that causes this disease can enter the mother's body through sexual intercourse or through the blood. It freely penetrates the placenta to the baby.

Complications in a newborn caused by the hepatitis B virus:

• Liver diseases.
• Retardation of mental and physical development.
• Miscarriage or stillbirth.

It must be remembered that in the absence of symptoms in a pregnant woman, the disease is transmitted to the baby.

Chicken pox

It would seem that this is a harmless disease that almost all of us suffered from in childhood. But chicken pox can cause severe complications if a pregnant woman contracts it. The risk is especially high when experiencing the disease in the third trimester.

Intrauterine infection with chickenpox threatens:

• Characteristic rash.
• Blindness (due to optic nerve atrophy).
• Underdevelopment of the limbs.
• Pneumonia.
• Underdevelopment of the central nervous system.

The above pathologies are referred to as congenital chickenpox syndrome. A woman can become infected with chickenpox through airborne infection.

If at one time the expectant mother already had chickenpox, then upon contact with a person who has all the symptoms, she will transfer immunoglobulins to the child - creating passive immunity.

Herpes

The herpes virus, acquired by the mother through sexual contact, is transmitted to the child when he passes through the birth canal.

Consequences caused by this disease:

• Characteristic rash.
• Increased body temperature.
• Pneumonia.
• Yellowness of the skin.
• Congenital anomalies of eye development.
• Brain pathologies.
• Miscarriage and stillbirth.

The herpes virus poses a great danger to the baby’s central nervous system. If brain damage occurs, meningitis, encephalitis, hydrocephalus, etc. develop. Such children have an increased risk of developing cerebral palsy. In this case, congenital herpetic infection does not appear immediately, but after about a month.

This virus is also characterized by transplacental transmission.

Syphilis

When a pregnant woman is infected with syphilis, there is a maximum chance that the fetus will also be infected. The expectant mother can only catch the disease through sexual intercourse. If, when hard chancre appears (the first stage of syphilis), you do not immediately begin treatment, then the following consequences are possible for the child:

• Delayed mental and physical development.
• Yellowness of the skin.
• Rash.
• Pathologies of the eyeballs of the ears, as a result – deafness and blindness.
• Underdevelopment of the limbs.
• Damage to tooth germs.
• Premature birth, stillbirth.

Even in the absence of obvious signs of syphilis, a woman can become infected with the fetus, so monitoring the mother’s health is mandatory both when planning pregnancy and at all its stages.

Tuberculosis

One of the most dangerous infections for a child is the causative agent of tuberculosis. If the mother was already sick with tuberculosis before pregnancy, then it is possible to carry and give birth to a healthy child only under the careful supervision of doctors. Many forms of tuberculosis and its combinations with other diseases serve as a reason for termination of pregnancy for medical reasons.

If a woman becomes infected during pregnancy (tuberculosis is spread by airborne droplets), there is a possibility of giving birth to a child already sick with tuberculosis.

Listeriosis

A pregnant woman can encounter listeriosis by eating low-quality meat and dairy products, unwashed vegetables, and through dirty hands after contact with animals. If for a mother infection with Listeria can go unnoticed or with minor intestinal disorders, then penetrating through the placenta, this bacterium causes a number of complications in the baby:

• Rash, ulcers on the skin.
• Sepsis.
• Brain lesions.
• Premature birth and stillbirth.

For any manifestations of such an infection in newborns, the prognosis is disappointing (about 40% of infants survive).

Toxoplasmosis

Consequences of toxoplasmosis in pregnant women:

• Brain lesions (meningitis, encephalitis, hydrocephalus).
• Blindness.
• Hepatomegaly, splenomegaly.
• Delayed mental and physical development.
• Premature birth, spontaneous abortion, miscarriage.

It is easy to avoid any of these infections - just take a responsible approach to the choice of sexual partners, maintain your immunity and regularly visit the doctor during pregnancy planning and the entire period of its management. Timely tests will help prevent the development of such terrible consequences.

TORCH syndrome is diagnosed when there is no exact etiological diagnosis, they do not know which fetus is the diagnosis. Diagnosing IUI is very difficult. It is necessary to examine not only the child, but also the mother, as well as the placenta and umbilical cord. An indirect diagnostic method is a blood test using ELISA for infections. However, even if a child has antibodies to any infection, this is not always evidence of IUI. After all, they could have been introduced into the child’s body from the mother. Then the child’s blood is taken again after 3-4 months, and if the antibody titer has increased 4 times or more, this is considered a diagnostically significant sign.

The causes of intrauterine infections during pregnancy are, as a rule, infection of the mother with these diseases. Infection of the fetus occurs more often precisely in the case of the first encounter of the mother’s body with infectious pathogens.

In turn, diagnosing intrauterine infections during pregnancy is almost impossible. There are only signs by which one can suspect trouble in a child. They are also determined using ultrasound.

Some symptoms of intrauterine infection during pregnancy that doctors pay attention to:

• delayed fetal development (determined by measuring the length of the uterus - with delayed development it grows slowly, and according to ultrasound data on the size of the head, limbs, volume of the torso);
• polyhydramnios or oligohydramnios;
• pathologies of the placenta;
• polycystic lung disease;
• hydrocephalus, etc.

Many women who have lost their children shortly before giving birth or within a few days after birth know the dangers of intrauterine infection during pregnancy. IUI is the most common cause of early childhood mortality. Approximately 80% of children born with developmental defects are diagnosed with IUI.

The consequences of intrauterine infections during pregnancy in a newborn child can be expressed in respiratory dysfunction, cardiovascular pathology, jaundice, feverish conditions, damage to the eyes, mucous membranes, encephalitis, etc.

Infection can occur in the following ways:

• through the blood, placenta, thus very easily penetrates into the child’s body, for example, toxoplasma - the causative agent of toxoplasmosis;
• from the genital tract, this happens with infections such as mycoplasmosis, chlamydia, etc., that is, those that are sexually transmitted are manifested precisely by damage to the genital organs;
• from the fallopian tubes;
• at the birth of a child in a natural way.

Prevention

Every woman planning a pregnancy should undergo a general examination before pregnancy to detect possible infections (they can be asymptomatic) and treatment if necessary. During pregnancy, you need to follow all known preventive measures to reduce the risk of contracting various infections. We will present several such measures.

1. Clean the animal toilet only with gloved hands, wash your hands. Be sure to cook the meat thoroughly and boil it well. Otherwise, you can become infected with toxoplasmosis, a very dangerous infection for a child.

2. Do not visit children's groups if you do not have a rubella vaccination and have not had it previously. If a woman gets rubella in the first trimester of pregnancy, she is advised to have an abortion, since this disease almost always causes severe malformations in the fetus, whose organs have just begun to form.

3. Do not travel on public transport or walk without a mask during the flu period. Any acute respiratory viral infection or acute respiratory infection, if severe, can kill a child. Don’t go out “in public” unless absolutely necessary. And if you go out, be sure to lubricate your nose with oxolinic ointment and wear a medical mask. Do not touch your face with unwashed hands. Wash your hands thoroughly with antibacterial soap after visiting clinics, hospitals, shops, or public transport.

4. If you have herpes, the infection can easily be transferred to your genitals. expectant mother. And genital herpes, and even at the first manifestations during pregnancy, almost always greatly affects the health of the unborn child.

This is part of the measures that are guaranteed to protect you and your child from some dangerous infectious diseases.

Intrauterine infection is a group of diseases caused by viruses, fungi or infections various types. They penetrate a woman’s body and cause the development inflammatory process. It is localized in the intimate area and affects the genitals.

In this case, there is a possibility of infection of the fetus, which can occur at different periods of pregnancy. The pathological process affects the fetus in various states from embryo to newborn.

In medicine, there are several forms of infection that can become a threat to the fetus and woman. These include:

In addition, infections can be combined, enhancing each other’s negative effects. This condition most dangerous, as there is severe suppression of the immune system. As a result, treatment is difficult.

Infection of the fetus always occurs from an infected mother, when fungi and pathogenic microorganisms penetrate the blood and lymph. There are several ways to transmit viruses:

• Hematogenous. Viruses and toxoplasma penetrate the embryo through the placenta.
• Ascending path. The infection initially reaches the genitals and penetrates the uterine cavity. This is how enterococci are transmitted.
• Descending path. Pathogens first penetrate the fallopian tubes and enter the uterus. Only after this are they transmitted to the fetus.
• Contact. Infection of the child occurs during its passage through the birth canal during birth. It is in close contact with the mother's mucous membrane. The virus also enters the newborn's body through amniotic fluid.

Viruses do not always activate immediately after entering the body. This occurs as a result of the influence of external factors. These include:

1. Pathologies of the genitourinary system. These could be , .
2. Various infectious and cold diseases suffered during pregnancy, for example ARVI.
3. Immunodeficiency.

Also provoking factors for the development of infection is the condition after tissue and organ transplantation. At the same time, the body’s immunity is greatly weakened and cannot resist viruses.

Main symptoms

The severity of the disease and clinical manifestations depend on many different factors. In the first week of pregnancy, when the embryo attaches to the walls of the uterus, when infected, the disease manifests itself in the death of the fetus.

In cases where infection occurs before the 8th week of pregnancy, there is also a possibility of fetal death, and placental dysfunction is also observed.Infection that occurs between 9 and 22 weeks manifests itself in the form of disruption of the functioning of certain organs and systems of the body.In the late fetal period, which begins at 22 weeks, fetopathy is observed.

Clinical manifestations appear immediately after birth or during the first 3 days. But many pathologies have a longer incubation period or appear earlier.

Infection of a child is manifested by the following symptoms:

• Regular regurgitation that occurs more often than necessary.
• Refusal to eat.
• Hypotonia of muscle tissue.
• Weakening of innate reflexes.
• Paleness of the skin.
• Changes in the frequency and rhythm of breathing.

During pregnancy, the presence of an infection of various origins can be determined by the following signs:

• The appearance of rashes on the skin in the form of ulcers or blisters.
• Otitis, rhinitis and conjunctivitis.
• The presence of wheezing in the lungs when breathing, shortness of breath, cyanosis of the skin.
• Diarrhea or bloating.
• Vomiting and weakened reflexes.

More information about TORCH infections can be found in the video:

The disease can also manifest itself in the form of sepsis, but diagnosing it in a newborn is difficult. This is due to a slow immune response. First, the presence of signs of general intoxication is noted. Then the child begins to lose weight, the umbilical wound does not heal well, then jaundice develops, and the liver and spleen enlarge.

Why is it dangerous?

To most pathogens, if a woman has ever encountered it, she develops immunity. During subsequent infection, the body’s defenses prevent pathogenic microorganisms and viruses from spreading. But if a certain type of infection first enters female body During pregnancy, infection occurs.

The severity of the pathology depends on the period at which the infection occurred.

On early stages the disease leads to fetal death or the development of severe defects that may be incompatible with life.

Infection in the later stages affects the formed organs. In this case it suffers. This is due to the fact that the development of the organ continues until birth. In addition, the infection negatively affects the liver, heart and lungs.

Diagnostics

During pregnancy, diagnosing intrauterine infection is difficult, since the disease is rarely accompanied by symptoms in the woman.

Even at the planning stage, the doctor conducts a diagnosis in order to identify pathologies that are sexually transmitted. Also during pregnancy, a woman needs to undergo regular tests. This is necessary to control the condition of the body, since during this period the immune system is weakened, resulting in increased susceptibility to various infections.

If there is a suspicion of the development of an intrauterine infection, a number of diagnostic measures are carried out. These include:

• . Prescribed to detect antibody levels.
• Laboratory examination of smears from the genital tract. Helps determine the presence of a virus.
• Genetic identification.
• Cardiotocography.
• After birth, a blood test and skin washes are also taken from the baby. The placenta is sent for histological examination.

It is possible to identify pathology at the preclinical stage only with the help of comprehensive diagnostics. Based on the results obtained, if necessary, the doctor determines the course of treatment.

Treatment and prognosis

Course of therapy and the need to use separate groups medicines depends on the type of pathogen. Treatment is always comprehensive, which allows you to influence the virus and increase immunity.

The following groups of drugs are prescribed:

• Antibacterial. "Erythromycin", "Gentamicin", "Ampicillin".
• Antiviral. Targeted drugs are used, depending on the type of pathogen.
• Immunostimulating. "Isoprinosine", "Dibazol".
• General strengthening. "Solyutab", "Amosin".

All medications must be prescribed by the attending physician, who will determine the required dosage in accordance with the severity of the disease and the stage of pregnancy.

The prognosis also depends on how long the infection occurs.

If the infection reaches the embryo and the inflammatory process begins at 1-3 weeks of pregnancy, then contact with the pathogen ends in the death of the fetus.Infection of the embryo at 4-12 weeks leads to the development of abnormalities in the formation of many systems and organs. Most often they are incompatible with life. This is due to the fact that the fetus does not have a defense mechanism, and the body cannot resist the activity of the pathogen.

Fetopathy develops in cases where the fetus becomes infected at 16 weeks. In this case, the occurrence of various defects is observed, for example, polycystic pulmonary disease, hydrocephalus. Encephalitis, pneumonia, and nephritis may also develop.The influence of viruses, fungi and pathogenic microorganisms in the future is manifested by signs of immaturity, a long period of adaptation, and large weight loss after birth.

In order to save the child and protect yourself from the negative consequences of pregnancy, you should closely monitor your health and avoid contact with sick people. An infection that enters the body during pregnancy becomes a threat to the life of the fetus and the health of the mother.

Prevention

In order to avoid infection entering the body and its development at the planning stage and during pregnancy, a number of recommendations should be followed. Experts advise:

1. Pass diagnostics to determine the presence.
2. Donate blood for analysis to determine the level of antibodies to various pathogens.
3. Six months before the expected pregnancy, get all the necessary vaccinations.
4. Do not contact with sick people, as the infection can be transmitted through contact.
5. If there are pets in the house, such as cats or dogs, they must be taken to a veterinary clinic for examination.
6. Eliminate foods from your diet instant cooking, fast food.
7. Meat and fish should be well cooked, and exotic cuisine should be completely abandoned at the planning stage and during the gestation period.
8. Visit your gynecologist regularly.
9. If you suspect pregnancy, contact a medical institution in order to register with the antenatal clinic.
10. Prepare for the upcoming pregnancy in a timely manner.
11. Treat all infectious diseases in a timely manner, as they cause the development of an inflammatory process and complications.

The pregnancy period is a very important stage in the life of every woman. At this time, you should not only take care of your health. Each disease, especially if the cause of its development is an infection, can negatively affect the formation of the fetus. That is why it is necessary to follow preventive measures and monitor your health.