According to statistics, approximately 10-15% of newborns are susceptible to intrauterine infection. The urgency of this problem is due to the high frequency of reproductive losses, early neonatal morbidity, which often leads to disability and mortality.
Intrauterine infection (IUI) is the infection of the fetus or newborn with pathogenic microorganisms (viruses, bacteria, fungi, protozoa) as a result of their transmission to the child from a sick mother, but at the same time he does not have any symptoms of the disease.
IUI is a rather severe pathology , which in most cases determines the mortality rate of newborns. According to scientific data, the etiological factor of the sudden death of newly born children is precisely the infection, which proceeds, as a rule, without obvious symptoms.
Ways of Transmission Of Infection:
Hematogenous, that is, through the blood.
Ascending, that is, from the genital area and urethra into the uterine cavity.
Descending, that is, from the inflamed appendages into the uterine cavity.
Intranatal, that is, in the process of the passage of the fetus through the birth canal.
Mixed.
This diagnosis is established on the basis of a laboratory study of blood, cerebrospinal fluid and the detection of class M immunoglobulins and low-avid class G immunoglobulins in them in blood taken from the umbilical cord.
Reasons For IUI
- Inflammatory and infectious diseases of the urogenital system of a pregnant woman: urethritis, cystitis, oophoritis, adnexitis, pyelonephritis, salpingitis, syphilis, gonorrhea, HIV.
- Past diseases of the respiratory system of a woman: ARVI, acute respiratory infections, tonsillitis, pharyngitis, tonsillitis, influenza, pneumonia, herpes.
- Preeclampsia, eclampsia during pregnancy.
- Threat of spontaneous abortion.
- Dysfunction of the uteroplacental barrier.
- Childbirth up to 37 weeks.
- Congenital pathology of the central nervous system in the fetus.
- Complicated course of the intrapartum period.
- Iatrogenic infection of the fetus during invasive procedures: chorionic villus sampling, amniocentesis, cordocentesis.
Intrauterine infection of a newborn is a rather serious pathological condition that can cause the most negative consequences and dangerous complications.
Effects
- Premature birth, early rupture of amniotic fluid.
- Miscarriages, missed pregnancies. They are due to teratogenic and embryotoxic effects. On ultrasound, you can see the deformation of the ovum, detachment and hypoplasia of the chorion, shortening of the cervix.
- Fetal growth retardation.
- Placental insufficiency.
- Polyhydramnios, lack of water.
- Low birth weight baby.
- Fetal developmental anomalies.
- Fibrosclerotic organ deformities.
- From the liver: hepatitis, hepatomegaly, cirrhosis.
- From the side of the heart: carditis, persistent tachycardia, cardiovascular failure, endocardial fibroelastosis.
- From the nervous system: meningitis, encephalitis, meningoencephalitis, convulsive syndrome, epilepsy, cerebral palsy, microcephaly, muscle weakness, cystic formations and calcifications in the brain, pyramidal and extrapyramidal syndromes, chronic headache.
- Damage to the auditory nerve, hearing loss.
- Congenital immunodeficiency states.
- From the respiratory system: pneumonia, pneumosclerosis, pleurisy, respiratory failure, polycystic lung disease.
- From the side of the organs of vision: strabismus, cataract, microphthalmia, myopia, chorioretinitis, conjunctivitis, optic atrophy, dacryocystitis, blindness.
- Infectious skin lesions: jaundice, exanthema, pyoderma, roseola.
- Infectious mastitis.
- Dropsy or edematous syndrome in the fetus: ascites, hydrothorax.
- Damage to the hematopoietic organs with the development of anemia, thrombocytopenia, hemorrhagic syndrome.
- From the stomach and intestines: gastritis, colitis, enterocolitis.
- Mental retardation, speech disorder and psychomotor development in the future.
- From the side of the kidneys: polycystic disease, nephritis.
- Placental pathology: placentitis, chorioamnionitis.
- Sepsis, septic shock.
- From the side of the psyche: mental and neurological disorders, asthenia,
- Chronic fetal hypoxia, up to asphyxia.
- Lifetime disability.
- Stillbirth.
- Death of a newborn.
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Recommendations
- Pregnancy should be planned .
- All infections that a woman had before pregnancy should be treated promptly , including sexually transmitted infections.
- During pregnancy, in no case contact with sick people, limit communication with pets.
- Eat right , do not eat raw fish. Before eating meat and fish, they must be thoroughly roasted.
- You should regularly visit your doctor, do not miss appointments.
- Timely registration contributes to the early detection of various abnormalities in both the woman and the fetus.
- All women who have not had rubella before should be vaccinated 3 months before the intended conception.
Conclusions
The emergence of new methods of diagnosis and treatment of this pathology does not change the situation with IUI in any way, being still an urgent problem both in obstetrics and in pediatrics and neonatology. As a result, all this undoubtedly affects the steady growth of IUI, the high growth of reinfection.
The problem is complicated by the fact that to date, the role of mixed infection in the onset and course has not been sufficiently studied, the hormonal and immune status of the patient is not taken into account, the criteria for identifying persons with curable IUI are not fully formed. The problem of laboratory identification of causative agents of the disease remains relevant .
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