Modern problems of science and education. Intrauterine infections in newborns

Developing in the mother's belly, the child is relatively safe. In relative terms, since even in such sterile conditions there is a risk of developing an infectious disease. This large group of diseases is called intrauterine infections. During pregnancy, a woman should especially carefully monitor her health. A sick mother can infect her child during fetal development or during childbirth. We will discuss the signs and methods of diagnosing such diseases in the article.

The danger of intrauterine infections is that they unceremoniously interfere with the formation of a new life, which is why babies are born weak and sick - with defects in mental and physical development. Such infections can cause the greatest harm to the fetus in the first 3 months of its existence.

Intrauterine infection during pregnancy: what statistics say

A timely diagnosed and treated infectious disease in a pregnant woman poses minimal danger to her child.
Infectious agents pass from mother to baby in 10 out of 100 pregnancies.
0.5% of infants infected in the womb are born with corresponding signs of the disease.
An infection that has settled in the mother’s body does not necessarily pass to the fetus, and the child has a chance to be born healthy.
A number of infectious diseases that do not promise anything good for the baby may be present in the mother in a latent form and have virtually no effect on her well-being.
If a pregnant woman gets sick with one or another infectious disease for the first time, there is a high probability that her child will also become infected.

Intrauterine infection - ways of infecting the embryo

There are four ways in which infectious agents can enter a tiny growing organism:

hematogenous (transplacental) – from the mother, harmful microorganisms penetrate to the fetus through the placenta. This route of infection is characteristic of viruses and toxoplasma;
ascending - infection occurs when the infectious agent rises through the genital tract to the uterus and, having penetrated its cavity, infects the embryo. So the baby may develop chlamydial infection and enterococci;
descending – the focus of infection is the fallopian tubes (with adnexitis or oophoritis). From there, the pathogens penetrate the uterine cavity, where they infect the child;
contact - infection of the baby occurs during childbirth, when it moves through the birth canal of a sick mother. Pathogens enter the child’s body after he has swallowed infected amniotic fluid.

Intrauterine infection at different stages of pregnancy: consequences for the child

The outcome of infectious infection of the fetus depends on at what stage of intrauterine development it was attacked by dangerous microorganisms:

pregnancy period 3 – 12 weeks: spontaneous termination of pregnancy or the appearance of various developmental anomalies in the fetus;
gestation period 11 – 28 weeks: the fetus is noticeably delayed in intrauterine development, the child is born with insufficient body weight and various malformations (for example, congenital heart disease);
pregnancy period after 30 weeks: developmental anomalies affect the fetal organs, which by this time have already formed. The infection poses the greatest danger to the central nervous system, heart, liver, lungs and visual organs.

In addition, congenital infection has acute and chronic forms. The following consequences indicate acute infection of a child at birth:

state of shock;
pneumonia;
sepsis (blood poisoning).

Some time after birth, acute intrauterine infection in newborns may manifest itself with the following signs:

excess daily sleep duration;
poor appetite;
insufficient physical activity, which decreases every day.

If the congenital infection is chronic, there may be no clinical picture at all. Distant signs of intrauterine infection include:

complete or partial deafness;
mental health disorders;
vision pathologies;
lagging behind peers in motor development.

Penetration of infection to the fetus through the uterus leads to the following consequences:

stillbirth of a baby;
intrauterine embryonic death;
frozen pregnancy;
spontaneous abortion.

The following pathological consequences are recorded in children who survived such infection:

heat;
rash and erosive skin lesions;
non-immune hydrops fetalis;
anemia;
enlarged liver due to jaundice;
pneumonia;
pathologies of the heart muscle;
pathology of the eye lens;
microcephaly and hydrocephalus.

Intrauterine infection: who is at risk

Every expectant mother runs the risk of being captured by an infectious agent, because during pregnancy her body’s defenses are depleted to the limit. But the greatest danger awaits women who:

already have one or more children attending kindergarten or school;
are related to the medical field and are in direct contact with people who may be potential carriers of infection;
work in kindergarten, school and other children's institutions;
have had 2 or more medical terminations of pregnancy in the past;
have inflammatory diseases in a sluggish form;
faced untimely rupture of amniotic fluid;
have had a previous pregnancy with abnormal embryo development or intrauterine fetal death;
have already given birth to a baby with signs of infection in the past.

Symptoms of intrauterine infection in a woman during pregnancy

Doctors identify several universal signs that suggest that the expectant mother has contracted an infectious disease:

sudden increase in temperature, fever;
shortness of breath when walking or climbing stairs;
cough;
rash on the body;
enlarged lymph nodes that react painfully to touch;
painful joints that appear swollen;
conjunctivitis, lacrimation;
nasal congestion;
painful sensations in the chest.

This set of indications may also indicate the development of allergies in a pregnant woman. In this case, there is no threat of infectious infection of the fetus. Be that as it may, the expectant mother should go to the hospital as soon as at least one of these symptoms appears.

Causes of intrauterine infection during pregnancy

The activity of ubiquitous pathogenic microorganisms is the main cause of morbidity among women who are preparing to become mothers. Many bacteria and viruses, entering the mother's body, are transmitted to the child, provoking the development of serious anomalies. Viruses responsible for the development of acute respiratory viral diseases do not pose a danger to the fetus. A threat to the child’s condition appears only if a pregnant woman develops a high body temperature.

One way or another, intrauterine infection of the baby occurs exclusively from the sick mother. There are several main factors that can contribute to the development of infectious pathology in the fetus:

Acute and chronic diseases of the mother in the genitourinary system. Among them are such inflammatory pathologies as cervical ectopia, urethritis, cystitis, and pyelonephritis.
The mother has an immunodeficiency state or HIV infection.
Organ and tissue transplantation that the woman has undergone in the past.

Intrauterine infections: main characteristics and routes of infection

Cytomegalovirus (CMV)

The causative agent of the disease is a representative of herpes viruses. You can get the disease through sexual and close household contact, through blood (for example, through a transfusion from an infected donor).

During the primary infection of a pregnant woman, the microorganism penetrates the placenta and infects the fetus. In some cases, the baby does not experience any abnormal consequences after infection. But at the same time, statistics say: 10 out of 100 babies whose mothers encountered an infection during pregnancy have pronounced signs of intrauterine infection.

The consequences of such an intrauterine infection during pregnancy are as follows:

spontaneous abortion;
stillbirth;
hearing loss of sensorineural origin;
low birth weight;
hydro- and microcephaly;
pneumonia;
lag in the development of psychomotor skills;
pathological enlargement of the liver and spleen;
blindness of varying severity.

Cytomegalovirus under a microscope

If the infectious lesion is of a general combined nature, more than half of the babies die within 2 to 3 months after birth. In addition, consequences such as mental retardation, hearing loss and blindness are likely to develop. With mild local damage, the consequences are not so fatal.

Unfortunately, there are no medications yet that can eliminate the symptoms of CMV in newborns. If a pregnant woman is diagnosed with cytomegalovirus infection, the pregnancy is abandoned because the child has a chance to remain healthy. The expectant mother will be prescribed an appropriate course of treatment to minimize the effect of the disease on her body.

Intrauterine infection - herpes simplex virus (HSV)

A newborn baby is diagnosed with a congenital herpes infection if his mother is diagnosed with herpes simplex virus type 2, which in most cases is contracted through unprotected sexual contact. Signs of the disease will appear in the child almost immediately, during the first month of life. Infection of the baby occurs mainly during the birth process, when it moves through the birth canal of the infected mother. In some cases, the virus reaches the fetus through the placenta.

When a child’s body is affected by a herpes infection, the consequences are severe:

pneumonia;
visual impairment;
brain damage;
skin rash;
heat;
poor blood clotting;
jaundice;
apathy, lack of appetite;
stillbirth.

Severe cases of infection result in mental retardation, cerebral palsy and a vegetative state.

Herpes simplex virus under a microscope

Intrauterine infection - rubella

This disease is rightfully considered one of the most life-threatening embryos. The route of transmission of the rubella virus is airborne, and infection is possible even over a long distance. The disease, which poses a particularly great threat before the 16th week of pregnancy, “programs” various deformities in the development of the baby:

low birth weight;
spontaneous abortion, intrauterine death;
microcephaly;
congenital anomalies of the development of the heart muscle;
hearing loss;
cataract;
various skin diseases;
pneumonia;
unnatural enlargement of the liver and spleen;
meningitis, encephalitis.

Intrauterine infection - parvovirus B19

The presence of this virus in the body provokes the development of a disease known as erythema infectiosum. In adults, the disease does not manifest itself in any way because it is latent. However, the consequences of the pathology for the fetus are more than serious: the child may die before birth, and there is also a threat of spontaneous abortion and intrauterine infection. On average, infected children die in 10 cases out of 100. At 13–28 weeks of pregnancy, the fetus is especially defenseless against this infection.

When infected with parvovirus B19, the following consequences are noted:

swelling;
anemia;
brain damage;
hepatitis;
myocardial inflammation;
peritonitis.

Intrauterine infection - chickenpox

When an expectant mother is infected with chickenpox, the infection also affects the child in 25 out of 100 cases, but symptoms of the disease are not always present.

Congenital chickenpox is identified by the following characteristics:

brain damage;
pneumonia;
skin rash;
delayed development of eyes and limbs;
optic nerve atrophy.

Newborn babies infected in the womb are not treated for chickenpox, since the clinical picture of the disease does not progress. If a pregnant woman “caught” an infection 5 days before giving birth or later, the baby will be given an injection of immunoglobulin after birth, since there are no maternal antibodies in his body.

Intrauterine infection - hepatitis B

You can get a dangerous virus during sexual intercourse with an infected person in the absence of barrier methods of contraception. The causative agent of the disease penetrates the baby through the placenta. The most dangerous period in terms of infection is from 4 to 9 months of pregnancy. The consequences of infection for a child are:

hepatitis B, which can be treated with the appropriate approach;
liver cancer;
indolent form of hepatitis B;
acute form of hepatitis B, which provokes the development of liver failure in the child and he dies;
delay in the development of psychomotor functions;
hypoxia;
miscarriage.

Intrauterine infection - human immunodeficiency virus (HIV)

HIV infection is a scourge for special immune lymphocytes. In most cases, infection occurs during sexual intercourse with a sick partner. A child can become infected while in the womb or during birth. Intensive complex treatment is recommended for HIV-infected children, otherwise they will not live even two years - the infection quickly “eats” the weak body. Infected children die from infections that do not pose a mortal danger to healthy children.

To confirm HIV in an infant, the polymerase chain reaction diagnostic method is used. It is also very important to promptly detect the infection in the body of a pregnant woman. If the baby is lucky enough to be born healthy, the mother will not breastfeed him so that the infection is not transmitted to him through milk.

Intrauterine infection - listeriosis

The disease develops as a result of the activity of the Listeria bacterium. The microorganism easily penetrates the fetus through the placenta. Infection of a pregnant woman occurs through unwashed vegetables and a number of food products (milk, eggs, meat). In women, the disease may be asymptomatic, although in some cases fever, vomiting and diarrhea are noted. In an infected baby, the signs of listeriosis are as follows:

rash and multiple accumulations of pustules on the skin;
inflammation of the brain;
refusal of food;
sepsis;
spontaneous miscarriage;
stillbirth of a baby.

If signs of listeriosis become obvious in the first week after birth, then babies die in 60 cases out of 100. After confirmation of listeriosis in a pregnant woman, she is prescribed a two-week course of treatment with Ampicillin.

Intrauterine infection - syphilis

If a pregnant woman has syphilis, which she has not treated, the probability of infecting her child is almost 100%. Out of 10 infected babies, only 4 survive, and those who survive are diagnosed with congenital syphilis. The child will become infected even if the mother’s disease is latent. The results of the infection in the child’s body are as follows:

tooth decay, damage to the organs of vision and hearing;
damage to the upper and lower extremities;
formation of cracks and rashes on the skin;
anemia;
jaundice;
mental retardation;
premature birth;
stillbirth.

Intrauterine infection - toxoplasmosis

The main carriers of toxoplasmosis are cats and dogs. The causative agent of the disease enters the body of the expectant mother when she takes care of a pet or, out of habit, tastes meat with an insufficient degree of heat treatment while preparing dinner. Infection during pregnancy poses a great danger to the intrauterine development of the baby - in 50 cases out of 100, the infection overcomes the placental barrier and affects the fetus. The consequences of a child becoming infected are as follows:

damage to the organs of vision;
hydrocephalus;
microcephaly;
abnormally enlarged liver and spleen;
inflammation of the brain;
spontaneous abortion;
delay in the development of psychomotor functions.

Cytomegalovirus, rubella, toxoplasmosis, herpes, tuberculosis, syphilis and some other diseases are combined into a group of so-called TORCH infections. When planning a pregnancy, future parents undergo tests that help identify these pathological conditions.

Tests for intrauterine infections during pregnancy

Over the course of 9 months, the expectant mother will have to undergo more than one laboratory test so that doctors can make sure that she is healthy. Pregnant women take a blood test for hepatitis B and C, and syphilis. The PRC method is also used for pregnant women, thanks to which it is possible to detect active viruses in the blood, if any. In addition, expectant mothers regularly visit the laboratory to take a vaginal smear for microflora.

Ultrasound examination is of no small importance for successful pregnancy management. This method is absolutely safe for the fetus. And although this procedure is not directly related to the diagnosis of infectious diseases, with its help doctors can detect abnormalities of intrauterine development caused by pathogenic microorganisms. There is every reason to talk about an intrauterine infection if the following symptoms become obvious on an ultrasound:

Formed developmental pathologies.
Polyhydramnios or oligohydramnios.
Swelling of the placenta.
Enlarged abdomen and unnaturally enlarged structural units of the kidneys.
Enlarged internal organs: heart, liver, spleen.
Foci of calcium deposition in the intestines, liver and brain.
Enlarged ventricles of the brain.

In the diagnostic program for examining expectant mothers belonging to the risk groups we discussed above, a special place is occupied by the seroimmunological method for determining immunoglobulins. As necessary, doctors resort to amniocentesis and cordocentnesis. The first method of research is to study amniotic fluid, the second involves studying umbilical cord blood. These diagnostic methods are very informative in detecting infection. If the presence of an intrauterine infection is suspected in a baby, then the material for research is the baby’s biological fluids - for example, saliva or blood.

Danger of TORCH infections during pregnancy. Video

The deterioration of the baby's health is provoked by intrauterine infections during gestation.

The predominance of pathogens in the female body that tend to provoke inflammatory processes in the genital organs and other systems is called intrauterine infection (IUI). The most negative of the disease is the possibility of infecting the unborn fetus in the female body. The factor that infects the fetus is the blood that circulates throughout the body of the woman and the conceived child.

This is the most basic route of infection, but the possibility of infection entering the body of a conceived child through the birth canal cannot be ruled out. The disease is predominantly detected in women who lead an unhygienic lifestyle, but not in all cases. So, let's look at what types of infections there are and how they enter the fetus's body?

Types of intrauterine infections

Infection is a flexible concept, so the main causative agents of this disease are:

If, during infection, the following additional factors influence the female body, then problems not only with your own, but also with the baby’s health after birth cannot be avoided. Additional factors are:

Constant influence of mental shocks.
Work in production with increased hazard standards.
With the predominance of chronic diseases.
Consumption of alcohol, tobacco or drugs.

The risk of a child’s illness also increases if the predominant pathogen is in the woman’s body for the first time. Thus, not only the woman during pregnancy is at risk, but also her little inhabitants in the tummy.

Description of the IUI

Let us consider in more detail information about the causative agents of intrauterine infections. So, in medicine, a group of pathogens of this disease is called TORCH. What does this mean? Each letter of this abbreviation hides the name of the pathogen:

T - toxoplasmosis;
O - other or from English. Others. The other group includes: syphilis, chlamydia, hepatitis, measles, etc.;
R - Rubella or rubella;
C - cytomegalovirus pathogen;
H - Herpes.

Let's pay attention to those that are especially dangerous, and often predominant in the female body, and consider their main characteristics.

Toxoplasmosis - this type of infection is known throughout the world. First of all, it is worth mentioning that toxoplasmosis is the most dangerous pathogen. And such a virus is hidden mainly in domestic animals. A woman can become infected after eating the meat of an infected animal, or through blood and skin. The risk of infection increases if a woman has not had pets throughout her life. In this case, any contact with an infected animal causes consequences in the form of infection of the body. To eliminate the possibility of infection of the body with the toxoplasmosis virus, it is necessary to have contact with pets since childhood.

Chlamydia is an infection that can be transmitted through sexual intercourse. To reduce the risk of infection with chlamydia, you must use a condom during sexual intercourse.

Chlamydia during pregnancy is detected quite simply: for this, a smear is removed from the vagina and taken for analysis. If the analysis shows a positive result, then you should immediately begin appropriate treatment, which you can learn more about in the final sections of the article. It is imperative that if chlamydia is detected in a pregnant woman, it is also worth taking a test from her sexual partner and, if necessary, undergoing treatment. If the infection was detected already during pregnancy, then infection of the fetus is possible. But if the expectant mother is cured in time, then the child will not be in any danger.

Rubella is a disease that most often manifests itself in childhood. You get rubella once in a lifetime, and therefore if a woman did not have it in childhood and plans to join her family, then she should take care of getting a vaccine against the causative agent of this disease. The risk of contracting rubella without vaccination is very high, and the consequences will be very serious. The development of pathological abnormalities in a child cannot be ruled out, and signs of predominant intrauterine infection in a baby may appear even 1-2 years after birth. A blood test can detect the presence of rubella.

Cytomegalovirus - refers to bacterial microorganisms from the group of herpes viruses. The risk of infection is primarily determined by the period of gestation, but in rare cases it can also be provoked during childbirth. For a woman, the signs of the disease are practically invisible, which cannot be said about a child. Immediately after birth, on days 2-3, symptoms of intrauterine infection in a newborn baby become noticeable.

Herpes is the final IUI. First of all, it is worth noting that infection of the fetus with the herpes virus occurs through the birth canal, that is, when the child is born. If during pregnancy the predominance of the herpes virus in a woman’s body is diagnosed, then childbirth is carried out by Caesarean section. This is done to eliminate the risk of infection entering the fetus’s body when it is born.

Thus, each of the above pathogens of IUI has characteristic features. But why is such an infection dangerous, and what serious consequences can arise? To do this, consider the danger of IUI.

Consequences and dangers of IUI

The causative agents of IUI are common microbacteria that affect every person, especially in childhood, so protecting children from various diseases is wrong. Strengthening the immune system is formed not by taking vitamins (this is how immunity is supported), but by meeting various types of bacteria. It cannot be said that if a child does not get sick in childhood, then he has a strong immune system. It’s just that his parents carefully protect him from the influence of negative factors.

Based on this, it is worth noting that if a woman, as a girl, had contact with IUI viruses, then, consequently, her immunity has developed an “antidote.” A woman can get sick again, but the risk of complications and development of IUI will be minimal.

Depending on when infection occurs, negative consequences are caused.

If infection occurs from the beginning of conception until the 12th week, the consequences can be the most unfavorable: the risk of miscarriage, the occurrence of pathologies or malformations of the fetus cannot be excluded.
If the infection was provoked between 12 and 28 weeks of pregnancy, then the risk group for developing IUI does not decrease, and the consequences will be even more dangerous. In this case, there is a possibility of having a child with a heart defect or low birth weight.
If the infection occurs mainly in the late stages of gestation, the consequences can be tragic. IUI will have a direct negative impact on the already formed organs of the fetus, thereby causing their pathology. If measures are not taken, the baby may be born with ailments of the liver, lungs, heart or brain.

In addition, the possibility of infection of the genitourinary tract, encephalitis, meningitis and hepatitis cannot be ruled out. But the symptoms of these diseases do not appear primarily immediately, but several months after birth.

While kidney or liver diseases can be treated, abnormalities in the brain are difficult to diagnose and are not at all curable. In this case, the child may experience developmental deviations as he grows up. Often, IUI forms the causes of disability, so in order to eliminate such consequences and risk factors, it is worth taking appropriate measures.

Symptoms of the disease

It is very important to know the signs of the disease in order to identify them in time and take appropriate measures. First of all, in order to eliminate the risk of infection of the body, it is necessary to adhere to the test schedule. It is the analysis of blood and urine that gives a clear picture of the predominance of foreign bodies in the body of a pregnant woman. If the test is taken periodically, the risk group for contracting IUI is reduced. Even if something is detected at an early stage of infection, the virus can be eliminated without any problems, even without resorting to taking antibiotics.

To identify the development of IUI, it is necessary to take a blood and urine test, as well as undergo a medical examination. During the physical examination, a picture of inflammation and redness of the cervix and vagina will be observed. But examination in rare cases reveals infection of the body. What you should really rely on is blood and urine tests.

If signs of IUI were not detected in time in a woman during pregnancy, then the disease may affect the child with the following symptoms:

Low birth weight (up to 2 kg or less).
Developmental delay (physical and mental).
Lethargy.
The appearance of rash and jaundice.
Insufficiency of the cardiovascular and nervous systems.
Decreased appetite and pale facial skin.
Frequent regurgitation of food.

All of these signs appear mainly on the third day after birth, and if the infection occurred during childbirth, then the symptoms will appear immediately.

How does infection occur?

The most common routes of infection for IUI are blood and the birth canal. The method of infection depends, first of all, on the pathogen: if the infection is provoked through the sexual tract, the infection will reach the fetus through the fallopian tubes or vagina. If the rubella virus, endometritis or toxoplasmosis predominates in a pregnant woman, infection of the fetus occurs through the blood circulation, through the amniotic membrane or waters. The woman herself may be at risk of infection if she comes into contact with a sick person, during sexual relations, or through drinking raw water or unprocessed food. If simple hygiene measures are not followed, then the possibility of infection cannot be ruled out.

Treatment

Treatment is prescribed only if the disease is correctly diagnosed. Diagnostics involves the following procedures:

- take a blood test;
— vaginal smear analysis;
- Analysis of urine.

When the type of infection is determined, appropriate treatment is prescribed.

Depending on each individual case, personalized treatment is prescribed under the strict supervision of a doctor to eliminate the risk of developing pathologies.

Prevention

Prevention of the development of IUI should, first of all, include a complete examination of both partners who are planning to conceive a child. It also wouldn’t hurt to get vaccinated to prevent the risk of contracting the herpes virus.

Everything else follows the standard scheme: maintaining hygiene, proper and healthy nutrition, protection during sexual intercourse, treatment of all infectious diseases, giving up bad habits. If you follow all these points, the risk of developing IUI will be reduced to zero.

Any infectious diseases during pregnancy can cause infection of the fetus. Signs of pathology do not appear immediately, but the consequences can be very severe. Intrauterine infection (IUI) is difficult to diagnose and difficult to treat. Changes in the fetus are manifested by nonspecific symptoms, which cannot always be used to suspect an infection.

Etiology and prevalence

The reasons for the development of intrauterine infection of the fetus are associated with infection of the mother during pregnancy or with the activation of a chronic infection. The exact frequency and prevalence have not been established, not all pregnancies with infection result in childbirth, and the causes of early miscarriage are not always possible to determine. According to various studies, intrauterine infection accompanies up to 10% of all pregnancies.

Etiological factors are various types of microorganisms:

rubella, herpes, hepatitis, HIV viruses;
bacteria of syphilis, tuberculosis, STIs;
protozoa: toxoplasma;
fungi of the genus Candida.

A combination of several pathogens is also common.

There is a concept of a TORCH complex. This abbreviation stands for the Latin names of the most common pathogens that cause fetal diseases. These include:

T – toxoplasmosis;
O – other pathogens, which include syphilis, hepatitis, mycoplasma, candidiasis and many other infections;
R – rubella;
C – cytomegalovirus;
H – herpes.

Intrauterine infections in newborns cause death before 1 year of age in 30% of cases, and congenital malformations in 80% of cases.

Most often, the fetus is affected by viruses, much less often by bacteria and fungi. They can cause disease secondary to viral activation.

Consequences depending on the duration of infection

The greatest danger to the unborn child is primary infection of the mother during pregnancy. Her body must intensively produce protective antibodies, and therefore is not able to protect the fetus. If activation or re-encounter with the pathogen occurs, the consequences are less significant. The mother already has antibodies to the pathogen, so the disease is much easier, and the child is protected by maternal immunity.

The consequences of intrauterine infection for the fetus depend on the period when the infection occurred. In the first 2 weeks of embryo formation, the laying of the main tissues is disrupted, so spontaneous development occurs. It would be more correct to call the outcome of blastopathy a biochemical pregnancy, because the fertilized egg may be at the initial stage of implantation, and the woman will not know about her position. In this case, pregnancy can only be registered through blood tests.

When the pathogen penetrates during 2-10 weeks of gestation, severe malformations are formed, which are a consequence of cell damage and disruption of organ formation. They are often incompatible with life and end in fetal death, stillbirth or death in the first months of life.

Infection of the fetus between 11 and 28 weeks of gestation causes fetopathies. The fetal body is already capable of an inflammatory response; only some organs are affected. But the mechanism of inflammation is not complete. After the first phase - alteration, there is no second - exudation, as a result of which there is an influx of leukocytes and the release of substances that are aimed at localizing the infectious agent. The third phase of inflammation is pronounced - proliferation, when increased synthesis of connective tissue occurs and delimitation of the pathological focus occurs. Therefore, children infected during this period are born with defects of individual organs, often with fibroelastosis, hydronephrosis, and polycystic disease.

If the infection of the fetus occurs late, 28-40 weeks, then a full-fledged inflammatory reaction occurs, which involves several organs. A child is born with encephalitis, nephritis, hepatitis, pneumonia.

Infection can also occur at the time of birth. Inflammation of one or two organs develops, most often the lower respiratory tract and liver are affected, pneumonia and hepatitis are diagnosed.

Signs of infection

Clinical signs of an infectious process in the fetus are nonspecific. During pregnancy, some infections can occur in women with minimal symptoms. Signs of intrauterine fetal infection include diagnosed fetoplacental insufficiency and (FGR). Inflammatory processes are often accompanied by polyhydramnios, less often oligohydramnios occurs.

Low placentation can also be an indicator of the presence of infection in the uterus, often chronic inflammatory processes such as endometritis.

An increase in the size of the fetal liver and spleen indicates an intrauterine disease. Pathology can be suspected at the birth of a child with stigmata of disembryogenesis. These are minor developmental anomalies that do not significantly affect the overall health, but indicate diseases that occurred in utero. These include:

abnormalities in the structure of the skull, low forehead, large brow ridges;
changes in the shape of the eyes, shape of the jaw and chin, curvature of the nose;
excessively protruding ears, lack of natural curvature, tragus;
curvature of the neck, folds of skin on it;
changes in the shape of the chest, abdominal hernia;
short or long fingers, their fusion, transverse groove on the palm, curvature of the fingers;
clitoral enlargement, cryptorchidism, small labia;
birthmarks and age spots, hemangiomas.

But to diagnose pathologies that arose in utero, it is necessary to detect 5 or more stigmas.

A newborn may have respiratory disorders and diseases of the cardiovascular system. Physiological jaundice is more difficult to tolerate and has a longer course. The skin may become covered with a rash, there are neurological disorders, and feverish conditions.

But an accurate diagnosis can only be made after diagnosis.

Risk factors

The mechanism of transmission of intrauterine infection can be of three types:

ascending – from the mother’s reproductive tract;
transplacental – from foci of chronic or acute infection in the maternal body;
descending - through the fallopian tubes;
intrapartum – during childbirth.

Considering the possible routes of infection of the fetus, a woman during the preconception period needs to sanitize the foci of existing infection. It is necessary to achieve remission in chronic infectious pathologies (tonsillitis, sinusitis, cystitis), sanitation of the oral cavity, and treatment of carious teeth.

Risk factors have been identified that increase the likelihood of developing IUI. An acute inflammatory process that occurs during pregnancy, especially for the first time, significantly increases the chances of infection of the fetus. In the first trimester, when the placenta has not yet formed, there is a greater likelihood of influence from bacterial flora. In subsequent trimesters, when the placenta is already capable of retaining large cells of pathogens, viral pathology more often develops.

Chronic lesions can lead to the spread of pathogens hematogenously, lymphogenously or by implantation. The risk of disease increases with decreased immunity. Mild immunosuppression is a natural process. This occurs under the influence of progesterone, which suppresses local protection to prevent rejection of the fertilized egg, which is partially foreign to the mother's body. But long-term chronic diseases, somatic pathologies, hypothermia and overheating, and stressful situations can further suppress the immune system.

Violation of placental permeability, which occurs during a pathological course of pregnancy, increases the possibility of the infectious agent passing to the fetus. The placenta itself is also affected; foci of hemorrhages, calcifications and various inclusions may appear in it, which impair the flow of blood to the fetus. This leads to its chronicity and developmental delay.

Poor social conditions are also a risk factor. Conditions arise for poor hygiene, and contact with infectious patients is possible. Women from low social strata are more likely to be infected with sexually transmitted infections.

Characteristics of major infections

Each disease has its own characteristics, pathogenesis, course and intrauterine infection.

Toxoplasmosis

Congenital toxoplasmosis develops when infected after 26 weeks; the likelihood of such an outcome increases as the time of birth approaches. If infection occurs in the early stages, spontaneous miscarriage or fetal death occurs.

The classic triad of signs is chorioretinitis, microcephaly and hydrocephalus. But it doesn't always happen. Given the severe malformations of the fetus and its disability, pregnant women who have had toxoplasmosis are offered abortion for medical reasons up to 22 weeks.

Herpes simplex

Herpes simplex viruses are most common among adults. The first type predominantly manifests itself as a rash on the lips, while the second affects the anogenital area. Viruses can remain latent for a long time and only appear when the immune system is weakened.

The placenta protects the fetus well from infection, so cases of congenital herpes are rare. Intrauterine herpes infection is possible with viremia in the mother during primary infection during gestation. If this happens in the early stages, spontaneous abortion is possible. In later stages, IUI is characterized by damage to various organs.

Late-term genital herpes can lead to infection during childbirth. If this is a relapse of the disease in the mother, then the child will be protected by her antibodies. With primary infection, severe damage to the newborn occurs.

For a newborn, herpes threatens neurological complications. Their severity depends on the time of infection. The earlier, the more extensive the damage to the nervous system and the more severe the manifestations. Signs of damage to the nervous system, encephalitis, do not appear immediately, but 2 weeks after birth. If left untreated, death occurs in 17%.

With primary infection of genital herpes (in the later stages), severe damage to the newborn occurs, often leading to death

Measles

The virus is transmitted by airborne droplets. Pregnancy does not affect the clinical manifestations of the pathology. The effect of the measles virus on pregnancy is controversial. The risk of teratogenicity is low, but there is evidence of damage to the membranes and the threat of premature birth in women with measles.

A newborn only becomes ill if the mother becomes ill 7 days before birth or within a week after birth. Manifestations of pathology can be different - from a mild course to a fulminant course, which ends in death. Infection postnatally leads to mild manifestations of the disease that are not dangerous for the child.

Diagnosis is carried out based on the characteristic clinical picture and by detecting antibodies. Treatment is symptomatic.

Vaccination against measles during gestation is contraindicated. But this pathology is included in the calendar of preventive vaccinations carried out in childhood.

Numerous types of intrauterine infections are diagnosed during pregnancy only when clinical manifestations of the disease occur. The exception is such dangerous diseases as HIV and syphilis. Also, a woman must be examined for gonorrhea. Smears, which are taken at regular intervals and when complaints of discharge occur, help sanitize the genital tract and prevent infection during childbirth.

Pregnant women are susceptible to the following conditions:

They often experience exacerbation of chronic foci of infection: carious teeth, hidden diseases in the kidneys and other internal organs. Before pregnancy, the body can still cope, the infection does not spread, but during pregnancy there is not enough strength for this.

transplacental: with the mother’s blood and through the lymphatic vessels;

Routes of infection to the fetus

For a child, the source of infection is always the mother’s body. However, if a woman suffers some kind of disease during pregnancy, this does not mean that intrauterine infection of the fetus always occurs and the baby will be born with a pathology. In some cases, the child’s body copes with the infection, or the mother’s immunity prevents the baby from becoming infected.

Depending on the agent (cause) of intrauterine infection (IUI), groups are distinguished:

bacterial: most often these are Escherichia coli, strepto- and staphylococcus and others;
viral: influenza, ARVI, enteroviral infections, HIV, etc.;

The most common group is the TORCH complex, which includes: toxoplasmosis, rubella, cytomegalovirus, herpes virus types 1 and 2, and some other infections.

A condition in which a woman became infected for the first time during pregnancy is considered more dangerous.. In this case, the body cannot protect the child from infection, since it itself only forms immunity against it. The baby becomes infected along with the mother, the consequences of which are the death of the fetus, birth in a serious condition, congenital defects that lead to profound disability of the child.

The danger of intrauterine infection during pregnancy is that it often goes unnoticed not only for the woman, but also for the child. In this case, doctors and the woman learn about it after the fact - after birth, or if the pregnancy is terminated for unknown reasons. Therefore, any signs of an acute inflammatory process in the expectant mother are an indication for adequate treatment.

Symptoms of intrauterine infection during pregnancy:

polyhydramnios or oligohydramnios according to ultrasound results;
delayed fetal development;

During childbirth, the high probability of intrauterine infection is evidenced by the following facts:

flabby placenta with areas of inflammation and necrosis (death) of tissue, yellow or green, with other visible changes (plaque, ulcers, etc.), changes in the umbilical cord.

Amniocentesis

congenital pneumonia;
inflammation of the umbilical wound - omphalitis;
conjunctivitis;
sepsis;
decreased hemoglobin levels;

Pathogenesis of hematogenous IUI and consequences for the fetus

Factors influencing complications from intrauterine infections:

Type of infection. Some pass without a trace, while others become the causes of the formation of defects; the progression of some can lead to the death of the baby.
The period during which the woman suffered from the infection. In the early stages, the relationship between the chorion and the mother’s body is not as close as later. Therefore, the likelihood of inflammation spreading to the baby is less. As the gestation period increases, the connection is so close that almost any infection spreads to both.
Mother's immunity. Primary infection during pregnancy is dangerous. If a woman has already been sick, there are antibodies in her body. Exacerbation of chronic infections is not so dangerous, although it is also fraught with serious complications.

Consequences of IUI for a child:

goes away on its own, with virtually no consequences for the baby’s health;

Pathogenesis of ascending IUI and consequences for the fetus

An approximate set of tests to detect infection:

. Helps detect the presence of antibodies in the blood. Class A and M immunoglobulins appear in the blood during acute and subacute infections. The higher their values, the more dangerous the inflammation is for the child. Class G immunoglobulins appear after immunity to a microbe is formed; they circulate in the blood throughout life. The doctor’s task is to determine exactly when, before or during pregnancy.
Bacteriological culture. For research, any material can be collected, depending on where the source of infection is suspected. Most often, a bacteriological examination of discharge from the genital tract (vagina and cervix), urine, contents of the rectal mucosa, oral cavity, nose, and pharynx is carried out.
Detection of obvious pathogens (for example, chlamydia, mycoplasma, etc.) or an excess of opportunistic pathogens (cause active infection only in large numbers) by more than 104 is an indication for active treatment.
PCR. Helps detect a pathogen even if its quantity is measured in units. Any biological fluid can be collected for research.

Ultrasound can identify indirect signs of involvement of the placenta and the child in the process (for example, swelling of the “baby place”, thickening of the walls, impaired blood flow, delayed fetal development, defects, etc.), assess the effectiveness of treatment and exclude other diseases.

After birth, to confirm intrauterine infection, biological fluid from the baby is taken for culture and PCR, for example, from the umbilical wound, eyes, etc. Also held histological examination of the placenta where active signs of inflammation are found.

Treatment of intrauterine infection:

Antibiotics. Prescribed if a bacterial infection or STI is suspected (for example, chlamydia, ureaplasma, mycoplasma are detected in the genital tract, high amounts of E. coli, streptococcus are detected in cultures, etc.). The choice of drug is determined by the sensitivity of microbes to it, which is indicated during culture. In some cases, broad-spectrum antibiotics may be prescribed. The duration of pregnancy and potential risks are also taken into account.
Antiviral drugs

Immunotherapy

Additionally, if necessary, drugs can be prescribed to improve the function of the placenta (metabolic drugs: Actovegin, to increase the speed of blood flow - Pentoxifylline and others).

It is necessary to try to avoid contact with sick people during pregnancy and avoid crowded places, especially children.
Examination for the TORCH complex in the absence of immunity, drawing up separate recommendations. For example, if a girl has never had rubella, she should be vaccinated against this infection and protect herself from infection during pregnancy. If there are no antibodies to toxoplasmosis, it is recommended not to own cats, as they are carriers of toxoplasmosis.

Read more in our article on intrauterine infections.

Read in this article

Causes of intrauterine fetal infection

In ordinary life, a woman’s body constantly encounters many bacteria and viruses. A good immune system allows you to encounter microbes, remember them and thereby create protection for all organs and tissues.

Microorganisms living in the intestines, on the vaginal mucosa, in the mouth and other mucous membranes are in a state of mutually beneficial cooperation with the body. They live and reproduce, in return for which a person receives various nutrients (microbes are involved in digestion) and protection from obvious pathogens.

Normally, there is a balance between those microbes and viruses that can cause diseases, and those that perform only a beneficial role for the body.

Causes of IUI

Pregnancy is a condition in which the functioning of all parts of the immune system changes. This is necessary for normal gestation of the fetus, which is half foreign to the woman’s body. The balance of beneficial and pathogenic microbes may be disrupted. Therefore, pregnant women are susceptible to the following conditions:

They are more likely to experience exacerbation of chronic foci of infection; carious teeth, hidden diseases in the kidneys and other internal organs. Before pregnancy, the body can still cope, the infection does not spread, but during pregnancy there is not enough strength for this.
They are more likely to catch various infections to which they were normally resistant. Flu, colds and other similar diseases are usually more complicated and have a large number of consequences for the body of a woman and child.

Thus, the cause of intrauterine infection in the fetus is:

exacerbation of chronic foci of inflammation in the mother; pathogens easily penetrate the placenta to the baby, especially in the second and third trimester;
infection during pregnancy; viruses and bacteria can enter the placental tissue, amniotic fluid and the baby in various ways.

The routes of penetration of pathogenic agents to the baby are as follows:

transplacental: can be hematogenous (with the mother’s blood) and lymphogenous (through lymphatic vessels);
ascending: through the cervix into deeper tissues, as a rule, sexually transmitted infections penetrate this way;
contact: with direct infection of the child from the mother during childbirth.

Expert opinion

Daria Shirochina (obstetrician-gynecologist)

For a child, the source of infection is always the mother’s body. However, if a woman suffers some kind of disease during pregnancy, this does not mean that intrauterine infection of the fetus always occurs and the baby will be born with a pathology. In some cases, the child’s body copes with the infection, or the mother’s immunity prevents the baby from becoming infected.

Classification

Depending on the agent that caused intrauterine infection (IUI), the following groups are distinguished:

bacterial: most often, these are Escherichia coli, strepto- and staphylococcus and others;
viral: influenza, ARVI, enterovirus infection, HIV, etc.;
fungal and caused by protozoa.

There is also a whole group of diseases that most often cause intrauterine infection in the fetus. This is a TORCH complex, which includes the following diseases:

rubella;
cytomegalovirus;
herpes virus type 1 and 2;
some other infections.

By the age of 18-20, about 80% of girls experience all infections from the TORCH complex in an asymptomatic form, and also under the guise of ARVI. In this case, during pregnancy there is a risk of pathogen reactivation and infection of the child. However, this rarely happens.

A more dangerous condition is considered to be one in which a woman did not get sick before pregnancy, but became infected for the first time during pregnancy. In this case, the body cannot protect the child from infection, since it itself only forms immunity against it.

The baby becomes infected together with his mother, the consequences of which are often serious - fetal death, birth in a serious condition, premature birth, congenital malformations that lead to profound disability of the child.

Watch this video about the most dangerous infections during pregnancy:

Symptoms during pregnancy

The danger of intrauterine infection during pregnancy is that it often goes unnoticed not only for the woman, but also for the child. In this case, doctors and the woman learn about it after the fact after the birth of the child (for example, if he is diagnosed with pneumonia, etc.) or if the pregnancy is terminated for unknown reasons.

Therefore, any signs of an acute inflammatory process in the expectant mother are an indication for adequate treatment, taking into account the possible potential risk of infection for the fetus.

During pregnancy, you can talk about intrauterine infection if the following symptoms are present:

threat of interruption up to 37 weeks: nagging pain in the lower abdomen, detection of hematomas and areas of detachment by ultrasound, bleeding;
or oligohydramnios as determined by ultrasound;
delayed fetal development;
other ultrasound signs, for example, detection of “flakes” in the amniotic fluid, disruption of blood flow in the vessels of the placenta and fetus, etc.

During childbirth, the following facts indicate a high probability of intrauterine infection:

cloudy amniotic fluid: yellowish, green, with an unpleasant odor, etc.;
flabby placenta with areas of inflammation and necrosis (death) of tissue, yellow or green, with other visible changes (plaque, ulcers, etc.), the umbilical cord is changed.

Intrauterine infection in a newborn is manifested by the following conditions:

congenital pneumonia;
inflammation of the umbilical wound - omphalitis;
conjunctivitis;
inflammatory changes in other areas of the skin;
sepsis;
jaundice, which does not respond well to standard treatment;
decreased hemoglobin levels;
hemorrhages in internal organs and brain;
low birth weight;
congenital malformations: cataracts, glaucoma, abnormalities in the structure of the heart, brain and many others.

Watch this video about the dangers of TORCH infection during pregnancy:

Consequences for the newborn

That, It’s difficult to say right away what the consequences of an intrauterine infection will be for the baby.. It all depends on:

Type of infection. Some pass without a trace, while others become the causes of the formation of defects; the progression of some can lead to the death of the baby in utero.
The period in which the woman suffered the infection. In the early stages, the relationship between the chorion and the mother’s body is not as close as later. Therefore, the likelihood of inflammation spreading to the baby is less than with transplacental transmission. As the gestation period increases, the connection in the mother-placenta-fetus system is so close that almost any infection spreads to both.
Mother's immunity. If a woman has previously encountered an infectious agent, she has already had a primary response to the pathogen, and antibodies circulate in the blood that capture those microbes that want to get to the baby. Therefore, primary infection during pregnancy is dangerous. Exacerbation of chronic infections is not so dangerous, although it is also fraught with serious complications.

leads to the threat of termination of pregnancy;

fetal malformations are formed;

death of a child inside the womb;

the birth of a baby with signs of intrauterine infection, the prognosis in the future depends on the severity and extent of the process; in many cases, brain damage is observed.

Watch this video about the causes, symptoms, diagnosis and treatment of IUI:

Blood analysis and other diagnostic methods

If an intrauterine infection is suspected, a series of tests must be performed. The type of test depends largely on the suspected pathogen. The most frequently performed examinations are:

Blood test (ELISA test). Helps detect the presence of antibodies in the blood. They come in different groups: Ig, G, M, A. Class A and M immunoglobulins appear in the blood during acute and subacute infections. The higher their values, the more dangerous the inflammation is for the child. Analysis for TORCH infections in pregnant women
- Bacteriological culture. For research, any material can be collected depending on where the source of infection is suspected. Most often, a bacteriological examination of discharge from the genital tract (vagina and cervix), urine, contents of the rectal mucosa, oral cavity, nose, and pharynx is carried out.
- Detection of obvious pathogens (for example, chlamydia, mycoplasma, etc.) or an excess of opportunistic pathogens (cause active infection only when present in large numbers) by more than 104 times is an indication for active treatment.
- PCR. Helps detect a pathogen even if its quantity is measured in units. For research, any biological fluid can be collected, as well as for bacteriological culture.
Additionally, an ultrasound examination is performed to confirm the presence of infection. It can identify indirect signs of involvement of the placenta and the child in the process (for example, swelling of the “baby place”, thickening of the walls, impaired blood flow, delayed fetal development, defects, etc.), as well as assess the effectiveness of treatment and exclude other diseases.

After birth, to confirm intrauterine infection, biological fluid from the baby is taken for culture and PCR, for example, from the umbilical wound, eyes, etc. A histological examination of the placenta is also carried out, where active signs of inflammation are detected.

Treatment of intrauterine infection

Treatment of intrauterine infections depends on their type, duration of pregnancy, and the condition of the mother and fetus. The following groups of drugs are used:
- Antibiotics. Prescribed if a bacterial infection or STI is suspected (for example, chlamydia, ureaplasma, mycoplasma are detected in the genital tract, high amounts of E. coli, streptococcus are detected in cultures, etc.). The choice of drug is determined by the sensitivity of microbes to it, which is indicated during culture.
- In some cases, broad-spectrum antibiotics may be prescribed. Treatment also takes into account the duration of pregnancy and potential risks for mother and baby.
- Antiviral drugs. They are used for presumably viral infections (herpetic, CMV, and others). The list of drugs approved during pregnancy is small: Acyclovir, drugs based on interferons.
- Immunotherapy. Prescribed to enhance the effectiveness of antibiotics and antiviral drugs, as well as in cases where there is no other treatment (for example, with toxoplasmosis, rubella and some other infections).
Additionally, if necessary, drugs can be prescribed to improve the function of the placenta (metabolic drugs: Actovegin, to increase the speed of blood flow - Pentoxifylline and others).

Prevention

Prevention of intrauterine infections during pregnancy is as follows:
- Planning pregnancy and maintaining all chronic diseases in the compensation stage. An examination for sexually transmitted infections is necessary, and if necessary, treatment based on the test results.
- During pregnancy, it is necessary to try to avoid contact with sick people and avoid crowded places, especially children.
- Examination for the TORCH complex in the absence of immunity, drawing up separate recommendations. For example, if a girl has never had rubella, she should be vaccinated against this infection and protect herself from infection during pregnancy. In the absence of antibodies to toxoplasmosis, it is recommended to avoid adopting new pets or cats, as they are carriers of pathogens.
Intrauterine infections are dangerous conditions, primarily for the child. They can lead to fetal malformations, disruption of the normal development of the baby, and even to his death or premature birth. It is important to promptly identify any active inflammatory processes in a woman’s body and provide appropriate treatment.

Intrauterine infections during pregnancy

Intrauterine infections are a group of diseases caused by various pathogens of a viral or infectious nature. Once in the mother's body, the pathogen provokes an inflammatory process that is localized in the genitals and not only. When a pregnant woman falls ill, she can infect her unborn child. Infection can occur at different periods of pregnancy, affecting the fetus from the embryonic state to the newborn.

The statistics are disappointing: about 10% of newborns are infected in utero. The risk of infection depends on a number of factors, such as:

maternal immunity status;

pathogen type;

epidemiological situation in a particular region.

Etiology

In the absence of proper treatment, the pathogen can live in the body for years, and the disease can be asymptomatic. The list of potential pathogens is quite wide - from the simplest fungi to bacteria and viruses.

The causative agents may be:

viruses of various etiologies (rubella, herpes simplex, enteroviruses ECHO, Coxsackie, cytomegaly, papilloma and parvovirus, influenza, measles, polio, human immunodeficiency virus);

bacterial agents (staphylococci, Treponema pallidum, chlamydia, Escherichia coli, Klebsiella, Protea, enterobacteria, streptococci);

fungal infections (type Candida);

mixed infections of a mixed nature. Caused by the presence of several infections or viruses.

After infection, serious diseases such as:

viral hepatitis;

cytomegalovirus;

listeriosis;

mycoplasmosis;

ureaplasmosis;

trichomoniasis;

There are several ways for infections to spread from mother to fetus:

Hematogenous-transplacental. This path is the most common. Viruses mainly penetrate through it, entering the placenta.

Transmural - through the infected endometrium into the uterus.

Descending - the inflammatory process is localized in the area of the uterine appendages.

Contact-placental (ascending) is a rather rare route. The infection passes from the mother's genital tract to the uterus, and then to the fetus. Typical for bacterial infections.

Contagious - when the fetus passes through the birth canal. In such cases, a Caesarean section is usually prescribed. The outcome of the birth will depend on the time when the infection occurred: the later, the greater the chance of a favorable outcome.

Signs of intrauterine infections

Often infectious diseases are completely asymptomatic. Sometimes inflammation of the internal genital organs is visible in the mirrors when examined by a gynecologist. In other cases, inflammation can only be detected by test results.

There are a number of signs and symptoms that are similar in etiology, but indicate completely different diseases. This may be a rash on the body and genitals, itching, burning, pain in the pelvic area. However, very often infections do not make themselves felt with obvious external signs.

Damage to the fetus at different stages of pregnancy has its own distinctive characteristics. There are two concepts: embryopathy and fetopathy.

Embryopathy is a disease of the fetus from the 2nd to the 10th week of pregnancy. At this time, spontaneous abortions or the development of true fetal defects are possible due to damage at the cellular level.

Fetopathy is a disease of the fetus between 10 and 40 weeks. It is characterized by complex developmental defects and can affect internal organs, the central nervous system, and the fetal brain.

Treatment of intrauterine infections during pregnancy

The doctor assesses the risk for the fetus and mother, makes a decision on medications, dosage regimen and dosage. Depending on the type of infection, even termination of pregnancy is sometimes indicated.

The main treatment methods are:

Taking antibacterial drugs, which are usually prescribed in the second trimester of pregnancy. During this period, the fetus is already protected by the placenta, and the negative impact of medications on it is significantly reduced. l Introduction of immunoglobulins, which can increase immune resistance. Used for viral infections, such as herpes. Preventing placental insufficiency: a healthy placenta is a kind of protective barrier. It reliably protects the fetus from the spread of infection. Prevention includes taking medications that improve blood circulation and reduce uterine tone. Metabolic complexes are often prescribed to improve fetal nutrition.

Prevention of intrauterine infections during pregnancy

The best way to prevent it is to plan a pregnancy. Both partners are required to go to a medical facility and undergo a full examination. Tests for all types of sexually transmitted infections, including hidden ones, are mandatory. If any virus or infection is detected, both men and women must undergo treatment. Afterwards the analysis is repeated. If the result is negative, the body must be given time to recover, and pregnancy planning is postponed during this period.