How to treat an infection in pregnancy: diagnosis, symptoms, choice of therapy

It is an axiom that pregnancy is the most important stage in a woman’s life. Keeping pregnant women healthy and preventing infections is one of the main tasks of the expectant mother and the doctor in charge of the pregnancy.

Continuous monitoring of well-being and laboratory tests to create an objective picture of the state of health of the pregnant woman in order to prevent or start treatment in time if the disease does develop is very important. This is due to the fact that infections during pregnancy can have the most serious consequences, including for the developing fetus in the form of dangerous complications. In addition to harming the health of the pregnant woman, it can be malformations and even life-threatening for her unborn child.

Causes of infections in pregnancy

The causes of infections in pregnancy can vary, as do the infectious diseases themselves. These can be both sexually transmitted infections and those that can be contracted through contact with infected people. During this period, the risk of contracting such infections increases significantly. This is due to the fact that the vaginal flora is disturbed, the hormonal balance changes, as well as due to the fact that the immune system of the pregnant woman during the period of pregnancy has physiological features.

An example is thrush – pregnant women have it 2-3 times more often than women in a normal state. Similarly, every fourth woman is diagnosed with bacterial vaginosis. This also applies to other infectious diseases that non-pregnant women might not be infected. However, a general decrease in immunity, among other things, leads to their development.

The danger of developing infections during pregnancy

Although any infection during pregnancy is undesirable, the most dangerous are those that are part of the so-called TORCH complex. This special term refers to the following infectious diseases – toxoplasmosis, rubella, cytomegalovirus, herpes. However, these diseases are not the only ones that pose a threat to pregnant women. There are other diseases, such as enterovirus, hepatitis B and C, chlamydia, syphilis, gonorrhea, chickenpox, listeriosis, HIV.

Some of these diseases may pass without consequences for all other categories of patients, but for the pregnant woman and her fetus appear to be extremely dangerous. They are especially undesirable in the 1st trimester, since, as a rule, they lead to

• Severe malformations of the central nervous system;
• congenital malformations;
• miscarriage;
• stillbirth.

Diagnosis of HST infections in the 1st trimester is a direct indication for termination of pregnancy.

Symptoms of infections in pregnancy

To recognize the most dangerous infections in pregnancy, it is worth having an idea of their main symptoms. In some cases, the disease after infection may be asymptomatic, but most often, by being attentive to your health, the expectant mother will be able to hear the warning “bells” and visit the doctor in time to prescribe adequate treatment.

Despite the fact that infection in the 2nd trimester is less dangerous for the baby than infections during pregnancy in the early terms, because its major systems and organs have already been formed, future mothers still need to know what disease may be indicated by a symptom or a set of symptoms. Of course, the doctor who is in charge of the pregnancy has the last word in diagnosis. It is important not only to know the symptoms of the most dangerous infectious diseases, but also how to reduce the risk of contracting them.

Toxoplasmosis and rubella – symptoms

Two very dangerous infections during pregnancy are toxoplasmosis and rubella. These diseases, which are practically harmless in normal circumstances, become a serious problem during pregnancy. Toxoplasmosis usually has no symptoms, but when the disease becomes acute or chronic, it is manifested by an increase in the spleen and liver, lymph nodes in the groin and under the arms, chills, fever, weakness. Sources of infection are cats, raw, undercooked meat. You should avoid contact with animals, wash fruits and vegetables with soap and water before eating.

Rubella is extremely dangerous in both the 1st and 2nd trimester and even in the last weeks of pregnancy. Its symptoms are a pink small rash all over the body, a fever of up to 38 degrees Celsius. The only way to protect yourself from infection is timely vaccination during pregnancy planning.

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Cytomegalovirus and herpes – how to recognize

Another formidable infection is cytomegalovirus (CMV). According to the symptoms, women take it for a trivial cold, which include weakness, elevated body temperature, inflammation and increased salivary glands, headaches, rapid fatigue, runny nose, sometimes – inflammation of the tonsils. Infection is fraught with disastrous consequences and complications for the fetus. It is transmitted sexually, through blood, saliva, breast milk, by household (through a towel or washcloth). Prophylaxis is good personal hygiene and the use of condoms.

Chronic infection is not so dangerous if it only goes to the acute phase during pregnancy, primary infection is more dangerous. The herpes virus can live in the body for years, manifesting itself during a cold with a slight fever, rashes on the lips, nasal mucosa, genitals, skin. The only way to avoid a primary infection is a general strengthening of the immune system.

Complications and Consequences

Knowing the symptoms of various infections in pregnancy, it is important to understand the seriousness of the diseases they cause. So, toxoplasmosis infection in the 1st trimester leads to a frozen fetus and miscarriage, in the 2nd trimester and 3rd – brain damage, eye damage to the baby, severe malformations. Infection with rubella has terrible consequences, such infection is an indication for termination of pregnancy.

It has a negative effect on the development of the fetus and is manifested in meningitis, reduced brain size, heart defects, changes in the eyeballs, congenital cataracts, encephalitis, deafness. If infected with CMV at an early stage, spontaneous miscarriage, fetal abnormalities are possible; at a later stage, congenital cytomegaly, polyhydramnios, premature births are possible. Herpes can lead to fetal death, miscarriage, liver and brain damage, and congenital malformations.

Consequences of other infections

Unfortunately, not only the TORCH complex poses serious risks to the development of the unborn child. Other infections during pregnancy are no less dangerous. For example, chickenpox, which is not on the TORCH list, may cause serious harm to both mother-to-be and the baby. For women, the infection is even more dangerous – against a background of immunodeficiency, she may develop pneumonia, which can be fatal. The virus is also dangerous for the fetus, resulting in fetal death or malformations.

Bacterial vaginosis is not so safe either; it can cause premature birth. Gonorrhea is also dangerous, which also leads to miscarriage and premature birth, fetal malformations, and after birth, the development of sepsis, meningitis, dermatological problems. Group B streptococcus can be transmitted by the mother to the baby and lead to negative consequences, up to the death of the infant.

Diagnosis of infections in pregnancy

It is possible to diagnose the presence of various infections during pregnancy by undergoing the necessary tests during the initial visit to the gynecologist after the fact of conception and registration of the woman for pregnancy and childbirth. The presence or absence of infections belonging to the TORCH complex is determined by testing the blood for antibodies of classes IgM, IgG to pathogens and determining their concentration.

If the number of antibodies to a certain type of infection is too high or there is an increase over time, this is evidence of an active pathological process. The doctor who prescribes the test analyzes the results and determines the time to repeat the test if they look doubtful to him. In all other cases, a diagnosis is made and a treatment regimen is developed for the pregnant woman.

Treatment of infections in pregnancy

How to treat an infection during pregnancy depends on what kind of infection is diagnosed by the results of blood tests taken by the expectant mother. Further tactics of treatment is developed by the doctor conducting the pregnancy, together with the expectant mother and takes into account all the risks that exist for the fetus, the impact on it of administered medications. In some cases, to determine if it is infected, an amniocentesis may be required – an invasive diagnostic intervention.

For example, for the treatment of cytomegalovirus infection in pregnancy, ancyclovir and valganciclovir are usually prescribed. For toxoplasmosis, spiramycin and sulfonamide can be prescribed, but they are fraught with adverse toxic effects on the fetus. However, based on the causes, symptoms and course of the disease, only the treating physician – often a gynecologist together with an infectious disease specialist – chooses the concept of the upcoming treatment.