Infections during pregnancy and the implications on the fetus

acquired during pregnancy by the mother can have significant negative effects on fetal development or viability. These infections can cause a multitude of harmful effects on the fetus or newborn, depending on the etiological agent involved. Article content\n \n \n . ro or from the SfatulMedicului mobile application (iOS, Android)\n . The causes of infections during pregnancy are diverse: either the lack of vaccination for some microorganisms, contact with infected people, engaging in activities with animals, etc. .

Factors that can influence the occurrence of infections during pregnancy\r\n. Their consequences are not necessarily worse for the mother, but cause important dangers for girls, respectively newborns. In certain cases, the infection can remain limited only to the mother without fetal transmission occurring. Toxoplasma\r\n . Manifestations of infection in the fetus or newborn include hydrocephalus, chorioretinitis, intracranial calcifications, convulsions.

The infection can also cause miscarriage. Sometimes, the condition is clinically similar to , caused by the Ebstein Barr virus. The diagnosis is made by testing the amniotic fluid for Toxoplasma gondii or by screening the mother's serum antibodies. It is recommended for the mother to avoid gardening, ingesting uncooked meat and unpasteurized milk, as well as handling cat litter. RUBELLA\r\n.

Manifestations in the fetus, but also in the newborn are: skin lesions, the appearance being similar to a \. There is also an increased risk of spontaneous abortion. The diagnosis of the disease can be made by early prenatal testing of IgG antibodies. There is no treatment if the infection develops during pregnancy. Also, there is no benefit from giving rubella immunoglobulin.

The mother should be vaccinated before trying to get pregnant. Measles\r\n. This can cause an increased risk of premature birth, spontaneous abortion and intrauterine growth restriction of the fetus. In addition, the risk of death at birth of the newborn is 20% in the case of full-term birth and 55% in the case of premature birth, if the transmission of the disease occurs. The clinical diagnosis in the mother is made by confirming the presence of IgG and IgM antibodies in the mother's serum after the development of the rash.

The treatment of infection during pregnancy is carried out by administering the mother's serum immunoglobulin. The vaccine is contraindicated during pregnancy, because the live attenuated virus in its component can cause fetal infection. It is recommended to vaccinate the mother before trying to get pregnant. Syphilis\r\n. Screening for the infection is carried out through early prenatal testing of anti-Treponema Pallidum antibodies, through the VDRL/RPR test (Venereal Disease Research Laboratory/Rapid Plasma Reagin), confirmation being carried out through the FTA-ABS test (fluorescent absorption test of treponemal antibodies).

Cytomegalovirus infection\r\n . Sometimes, the manifestations of the infection are similar to infectious mononucleosis. The diagnosis can be made by testing IgM antibodies or by testing viral DNA in the first weeks of life. If the infection occurs during pregnancy, no treatment is given. Antiviral drugs and proper hygiene can reduce the risk of disease transmission.

Infection with the herpes simplex virus\r\n. In addition, there is a high risk of neonatal death or central nervous system abnormalities if disease transmission occurs. The diagnosis is confirmed by virus culture or immunoassay. Cesarean delivery is recommended to avoid transmission of the disease if the mother has active lesions. An antiviral drug that can be useful in this situation.

Hepatitis B\r\n . The diagnosis is made through early prenatal screening of the surface antigen of the virus (HBs). The treatment consists of maternal vaccination, newborn vaccination and administration of immunoglobulin shortly after birth. HIV infection\r\n . The diagnosis is made through early prenatal maternal screening, requiring the mother's consent.

The treatment consists in the administration of antiretroviral drugs that significantly reduce the risk of transmission from mother to fetus. In general, it is indicated to continue the prescribed antiviral regimen during pregnancy, but the following antivirals must be avoided: Didanosine, Nevirapine, Efavirenz and Stavudine. Gonorrhea/chlamydia infections\r\n . The diagnosis is made by culture testing the secretions from the cervix and by immunological analyses. The treatment is carried out with antibiotics administered to the mother or the newborn.

chicken pox\r\n. If the birth occurs during an active infection, the risk of neonatal death is increased. The diagnosis is made by screening for IgG antibodies in the case of women who have not had or do not know of having had the disease in the past. For newborns, the diagnosis is made by testing IgM and IgG antibodies. The vaccine is contraindicated during pregnancy, because the live attenuated virus in its component can cause neonatal infection.

Varicella immune globulin administered to the unimmunized mother in the first 96 hours after exposure and to the newborn if the birth occurred during an active infection. Group B Streptococcus infection\r\n . The diagnosis is made by antigen screening after 34 weeks of pregnancy. The treatment consists in the administration of Beta-Lactamic antibiotics or intravenous drugs during labor or in infected newborns. Parvovirus B19 infection\r\n.

Testing is done by screening for IgM antibodies or viral DNA. The treatment consists in monitoring the fetal hemoglobin through the percutaneous sampling of blood from the umbilical cord and the administration of blood transfusion in case of severe anemia. . Urinary infections\r\n. The symptoms are the same as those occurring outside of pregnancy: feeling of urgency, stinging sensation when urinating, urination in reduced quantity and occurring more often than normal, pain in the lower abdomen and lower back, urine with an unpleasant smell or cloudy color.

The diagnosis is made by bacteriological testing of the urine and sometimes by cultures to select the right antibiotic. The treatment consists in the administration of an antibiotic that is safe to administer during pregnancy, for 3-7 days. It is important to prevent these infections, through sufficient hydration, urinating immediately after sexual activity and using toilet paper from front to back. In general, the screening for infections is carried out in the first trimester of pregnancy, at the initial visit, being carried out by the gynecologist. Thus, the usual blood tests, urine testing, cytology for HPV, RPR/VDRL, antibody titration for rubella and chicken pox, hepatitis B virus surface antigen (HBsAg), HIV screening (with the mother's consent) and .

Between weeks 32-37, the culture of the cervix will be collected for gonorrhea and chlamydia, as well as the screening for Group B Streptococcus. If you have any sign or symptom of infection during pregnancy, consult your gynecologist, because the consequences for the fetus can be harmful. Observe the periodic checks established together with your doctor, for a correct supervision of the pregnancy and the treatment of potential harmful conditions. The treatment is specific to each infection and must be determined by the gynecologist, because there are certain drugs that are contraindicated during pregnancy. To prevent infections, it is important to have all vaccinations up to date before becoming pregnant, to avoid contact with sick people or animals carrying diseases.