Infectious diseases in pregnancy, risks and treatment

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Catherine Le Nevez
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Infectious diseases in pregnancy

During the pregnancy contract some infectious diseases it can be very dangerous for the health of the baby. The major risks associated with these infections are miscarriage and fetal malformations.





It happens quite frequently that expectant mothers contract this type of disease; the doctors thus subject the mother to diagnostic tests in order to establish the dating of the infectious event. Indeed, determine as accurately as possible when the infection occurred it allows to predict with a certain reliability the risks for the health of the fetus.

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It is important to underline that an infectious pathology of the mother does not necessarily cause damage to the child, in fact only in the minority of cases the infectious microorganism manages to overcome the placenta barrier and to reach the fetus. Furthermore it must be said that the consequences of the infection can be very different depending on the gestational age. Infections contracted in the first trimester of pregnancy are those that carry the greatest risk of abortion and malformations because it is during this period that embryogenesis, ie the development of fetal organs, takes place.



It is possible to establish the time when the contact took place by researching and analyzing maternal antibodies; instead to investigate the health conditions of the fetus, amniocentesis is used, which allows searching for the DNA of the microorganism responsible for the infection.

If there is no trace of the organism in the amniotic fluid, fetal infection can be avoided. Even in cases where fetal infection is ascertained, there are not always negative consequences for the baby; the only system that allows to monitor the fetal situation is the ultrasound with which it is possible to study the fetal anatomy and identify any malformations of the fetus only if they are among those diagnosable with ultrasounds. However, even if the ultrasound picture is normal, it is not possible to 100% exclude that the newborn later develops diseases. Some types of infections, such as those of the retina caused by microorganisms such as toxoplasma, are not detectable by ultrasound but can cause serious illness in the newborn.

Toxoplasmosis in pregnancy

Toxoplasmosis is caused by a protozoan called Toxoplasma Gondii. This microorganism completes part of its life cycle in the cat's intestine, and therefore, once eliminated in the feces, can contaminate the surrounding environment. Humans can become infected by eating raw or undercooked meats, vegetables that have not been thoroughly washed, or by coming into contact with infected animals. Toxoplasmosis infection usually does not involve significant damage, it is often asymptomatic or can manifest itself with mild symptoms while if it is contracted during pregnancy the infection can have serious consequences on fetal well-being. In the case of maternal toxoplasmosis, as the gestational period advances, the chances of the infection reaching the fetus also increase. In case of fetal infection the damage is higher in the first quarter and gradually minors as the pregnancy progresses.

Toxoplasmosiv is often asymptomaticit is diagnosed through laboratory tests that are carried out from the beginning of pregnancy. If the mother is immune (that is, if she has already had the infection in the past) it will not be necessary to repeat the test. In the case of a non-immune woman (without antibodies), it is important to take all necessary precautions to avoid contracting the infection.

Here are the most important prevention rules:

  • avoid raw or undercooked meats;
  • wash the vegetables thoroughly;
  • wash your hands thoroughly after having contact with cats and after having been in contact with the ground.

In case of infection during pregnancy, prompt diagnosis and an equally prompt antibiotic treatment can reduce the risk of fetal harm.

Chickenpox in pregnancy

Chickenpox is a typical disease of childhood and it is very rare for it to be contracted during pregnancy. If chickenpox infection occurs in the first trimester of pregnancy it carries the risk of miscarriage or fetal malformations. The consequences are less serious if the mother contracts the disease during the second and third trimester of pregnancy. In this case, in fact, the antibodies produced by the mother are transmitted to the fetus. If the infection occurs a few days before delivery, the baby can be born healthy, but can manifest the disease even in a very serious form in the very first days of life having received the virus from the mother but not the antibodies. To prevent infection, it is important for the non-immune mother to avoid all possible contagion opportunities. If the infection occurs, it is useful to provide as soon as possible the administration of specific anti-virus immunoglobulins (antibodies).

Measles in pregnancy

Measles is a very common viral disease (Paramixovirus) in childhood. It shows up very rarely in unvaccinated or non-immune adults. If a pregnant woman becomes ill with measles in the first months of pregnancy, she faces an increased risk of miscarriage but it is very rare for the infection to reach the fetus. If, on the other hand, the woman becomes ill with measles in the 2 - 3 weeks before giving birth, it is possible that the baby will become ill with measles in the first days of life.

Mumps in pregnancy

Mumps (commonly known as "mumps") caused by a virus (paramixovirus) is also rare in adulthood. If a woman becomes ill with mumps in the first trimester of pregnancy, she has an increased risk of miscarriage. The extent of the risk of embryo-fetal infection is not well assessed. It generally is Vaccination during pregnancy is not recommended and the protection with specific antibodies is not very effective

Rubella in pregnancy

Rubella is a viral infectious disease that generally occurs with mild symptoms and does not involve particular damage. If contracted by a woman for the first time in the first trimester of pregnancy, the disease may be responsible for severe malformations fetal. The likelihood of fetal harm is greatest in the first weeks of pregnancy and tends to fade beyond 16-17 weeks. If, on the other hand, a woman who has already had rubella in the past, or is vaccinated, is exposed to the infection, any reinfection does not involve risks for the fetus. Fetal damage deriving from the rubella virus can be of various kinds: damage to the eyes (cataracts, glaucoma), deafness, cardiac malformations, possible psychomotor retardation. In addition to these damages, an increased risk of miscarriage in the first weeks of pregnancy is also possible.

To prevent these problems it is very useful to ascertain the existence of a woman's immunity even before pregnancy against the rubella virus. In the absence of immunity it is advisable to carry out vaccination and wait for aat least three months before trying to become pregnant

Read also: How to cure rubella in pregnancy

Cytomegalovirus in pregnancy

Cytomegalovirus (CMV) infections they are widespread among adults and almost always have no symptoms. Infected people, despite the presence of antibodies, for a long time eliminate the virus with saliva and urine. The virus can also be present in feces, semen and cervicovaginal secretions. The interest in pregnancy in this type of infection is due to the possibility of transmission of infection from mother to fetus which does not always occur. Transmission can occur through placental blood especially in the case of primary maternal infection (i.e. if the woman comes into contact with the virus for the first time) but, although less likely, it is also possible in the case of reinfection. Fetal infection does not usually cause miscarriage or malformations, but can lead to serious diseases affecting various organs of the baby. Frequently it can cause intrauterine growth retardation of the fetus, liver pain, microcephaly. In severe cases, children who actually contract the disease from their mother may die within months of birth or suffer permanent damage of varying degrees. In pregnant women, a periodic control of anti CMV antibodies similarly to controls for rubella and toxoplasmosis. A possible first infection is signaled by the presence of IgM antibodies. In this case, to diagnose fetal infection, it may be necessary to search for anti-CMV antibodies in fetal blood through the centesis cord, a particular prenatal diagnosis technique. After birth it will be necessary to submit the newborn to further tests. Unfortunately, there is no therapy for CMV infection; the possibility of prevention is also very limited, given the considerable spread of the virus.

Acuminate warts (HPV) in pregnancy

Condylomas are formations of warty type caused by the HPV virus They are usually located at the genital and perineal level. When they show up during pregnancy, theirs is appropriate removal by diathermocoagulation or laser vaporization. In very rare cases the condylomatous formations can reach conspicuous dimensions (giant condylomatosis) to the point of hindering vaginal birth and thus requiring a caesarean section. If the warts are present in the vagina and vulvar it is possible that the newborn becomes infected by crossing the birth canal. In these cases, doctors may decide to deliver the baby by caesarean section.

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