The development of intrauterine infection in newborns. Infectious diseases in newborns. Risk groups for diseases dangerous to the fetus

In this article, we will analyze the main infectious diseases in newborns: how to diagnose, prevent and treat.

Often these diseases occur due to weakened immunity at birth. In premature babies, the immune system is not fully formed, increased permeability of the skin and mucous membranes.

Often children get sick due to hospital infections, unsanitary conditions in the maternity hospital, infection from hospital staff, from other children in the general ward (when the infection is transmitted through the air).

Vesiculopustulosis

The disease is characterized by purulent inflammation on the skin of the child. Small blisters (vesicles) filled with a cloudy liquid appear on the body.

They burst after a few days, and scabs form in their place. Later they fall off, leaving no marks on the skin.

As a rule, such a disease is not dangerous and does not cause complications.

Small blisters (up to 1 cm in diameter) appear on the baby's skin, filled with pus and gray liquid. Usually appear in the lower abdomen, near the navel, on the legs and arms.

The disease can go into a severe stage: large blisters up to 3 cm in diameter. There is an intoxication of the whole organism. Urgent medical intervention required!

The infection usually clears up in 2-3 weeks. May end in sepsis.

Treatment: pierce the bubbles and treat the puncture site with alcohol solutions of aniline dyes.

Pseudofurunculosis

The disease begins as an inflammation under the scalp and spreads further. After piercing the bubbles, pus is found.

Localization: on the head under the hairline, on the neck, back and buttocks.

The main symptoms: fever, mild intoxication, sepsis, high levels of leukocytes in the blood.

Mastitis

The main cause of the disease is the improper functioning of the mammary gland. In the early days, it may not appear.

The newborn has an enlarged mammary gland. And when pressed, pus is released from the nipples.

The child constantly cries, refuses to breastfeed, symptoms of intoxication of the body appear.

Mastitis is dangerous with subsequent purulent complications for the whole organism. Therefore, do not delay your visit to the doctor.

streptoderma

The infection usually appears in the navel, in the groin, on the thighs, on the face and spreads further.

This is a very serious disease: the temperature is up to 40 degrees, the child becomes lethargic, refuses to eat, meningitis, diarrhea.

The disease can be complicated by toxic shock. In this case, you should immediately consult a doctor.

Phlegmon

This disease is characterized by purulent inflammation of the subcutaneous tissue. At the most severe stage, necrotic phlegmon (tissue necrosis) is observed.

The inflammatory-purulent process takes place on the chest and buttocks, rarely on the arms and legs.

It is easy to determine the onset of the disease: a slight inflammation appears, painful to the touch. Gradually it grows. The skin becomes dark purple, then dies (becomes pale and or gray on the second and subsequent days of the infectious disease).

If you cut the inflamed area of ​​​​the skin, pus and dead tissue will be found inside.

Symptoms of the disease: intoxication of the body, temperature up to 39 degrees, vomiting, a lot of leukocytes in the blood (leukocytosis).

With timely and proper treatment, it is usually possible to prevent the spread of infection, necrosis and skin rejection.

Omphalitis

This is an inflammation of the skin in the navel, may be with pus.

The disease is not dangerous for the health of the baby. Moms are advised to treat the wound with a 3% hydrogen peroxide solution 3 times a day. Then - a solution of potassium permanganate.

In case of illness in a newborn: the temperature rises, vomiting appears, regurgitation after feeding.

Conjunctivitis

The disease is characterized by inflammation of the lacrimal glands, swelling, sulfur from the eyes, constant tearing. May be complicated by deeper inflammation and ulcers.

Infection can occur in the hospital or from the mother.

Treatment: With a separate cotton swab for the right and left eyes, carefully remove the purulent discharge. Rinse several times a day with antibiotic solution. After washing, put eye ointment (penicillin).

Acute rhinitis

The disease is characterized by inflammation of the nasal mucosa. Pus starts to come out of the nose.

Subsequently, swelling of the nasal mucosa is possible. The child's breathing is difficult. The baby cannot breastfeed (cannot breathe through the nose), constantly cries, loses weight.

If the inflammation is not treated, it can spread to the middle ear, throat.

Treatment: suck out suppuration with suction. You can use sterile swabs with vaseline oil. Drip a solution of antibacterial drugs into the nose and insert gauze swabs (soaked in the solution) into each nostril for several minutes.

In the acute course of the disease, the doctor may prescribe antibiotic injections.

Acute otitis media

The disease is characterized by inflammation of the mucous membrane of the middle ear cavity.

Otitis can be purulent or serous. With serous otitis media, edematous fluid accumulates in the eardrum. With purulent otitis in the eardrum, severe swelling and suppuration.

It is not always possible to detect the disease, it proceeds secretly. The following can be distinguished infection symptoms:

If you find an infection, go to an appointment with an otolaryngologist. He will prescribe dry heat and UHF to the child.

Pneumonia

This is the most common infectious disease in newborns. It is characterized by inflammation of the tissues of the lungs. The baby can get sick in the womb or in the hospital.

In premature babies, inflammation takes a long time and can develop into purulent + necrosis of lung tissue.

The first symptoms of the disease:

Treatment:

Enterocolitis

An infectious disease characterized by inflammation of the mucous membrane of the small and large intestine. The work of the intestine is disturbed. The main pathogens: E. coli, salmonella, staphylococcus aureus.

Symptoms of the disease:

Treatment: proper nutrition and hydration therapy. The doctor may prescribe antibacterial drugs, therapy with large doses of bifidumbacterin and bactisubtil (normalize the normal functioning of the intestine).

Sepsis

A very dangerous infectious disease. Inflammation occurs due to the penetration of infection into the blood against the background of reduced immunity. Often the infection penetrates through the navel, damaged areas of the skin, wounds, mucous membranes, eyes.

After infection, a slight inflammation first appears at the site of penetration, then spreads to neighboring areas of the skin.

Purulent areas form on the skin, intoxication of the body occurs. Purulent metastases to the brain (meningitis), liver and lungs are possible.

Main symptoms:

Duration of sepsis in children:

Mortality among newborns with sepsis is 30-40%!

Sepsis treatment appoints the attending physician and conducts it under strict control. Typically, children are prescribed the following procedures:

At the beginning of treatment, drugs of general action are prescribed, then, according to the results of the impact on the flora, specific ones. For prolonged sepsis, use metronidazole. Simultaneously with antibiotics, you can give lactobacterin 3 times a day, vitamins.

Prevention of sepsis consists in strict observance of sanitary and epidemiological standards in hospitals and at home. Remember, newborns are most prone to infections, the risk of infectious diseases is very high. In premature babies, a weakened immune system is also added to this.

Attention! The information in this article is provided for informational purposes only. Do not self-medicate your child. Seek help from a specialist.

Intrauterine infection is called a viral, bacterial, fungal infection of the embryo, fetus or newborn during gestation or during childbirth. Depending on the type and severity of infection, this condition can lead to severe malformations of mental and physical development, hypoxia, death of the unborn child and, as a result, to premature birth.

Causes of intrauterine infection of the fetus

The pathological process can be caused by such microorganisms:

bacteria (damage by staphylococcus, streptococcus, tetanus, diphtheria bacillus);

viruses (rubella, chickenpox, influenza, cytomegalovirus, herpes);

fungi (for example, the genus Candida);

less often - protozoa (toxoplasma).

All these microorganisms can disrupt the normal development of an unborn baby during an acute or chronic illness of the mother, by:

transplacental penetration (herpes virus, cytomegalovirus, toxoplasmosis);

ascending infection (STDs, chlamydia, vaginal candidiasis);

descending infection (any inflammatory diseases of the ovaries and fallopian tubes);

direct contact (HIV/AIDS, hepatitis B, C).

Symptoms of intrauterine infection

Intrauterine infection is always the result of a mother's disease, which may be overt or latent. For example, a fetus can get a small amount of the rubella virus even if the mother is not sick but has been in contact with a sick person.

The same picture is typical for the defeat of the embryo by Toxoplasma - the mother is only a carrier of the simplest, which at the initial stage of the disease is very dangerous for the unborn child. In this case, there is a threat of intrauterine infection in the newborn.

Both individual facts and their combination can speak about congenital infection:

at a gestational age of up to 12 weeks: the threat of miscarriage, uterine hypertonicity, miscarriage, freezing of the embryo, diagnosing pathologies based on the results of ultrasound (malformations of the neural tube);

at a gestation period of 13-40 weeks: uterine hypertonicity, fetal death, the threat of premature birth, diagnosing pathologies based on ultrasound results (heart defects, myocarditis, brain malformations, congenital pyelonephritis and pneumonia, the level of development of internal organs does not correspond to the gestational age).

In some cases, the child may be born on time and be declared healthy, however, after a while, he may show signs of intrauterine infection - sepsis, osteomyelitis, progressive cataract, hepatitis.

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This is due to the possibility of transmission of microorganisms during childbirth or the so-called delayed pathology, the cause of which lies in infection during gestation.

How intrauterine infection affects preterm birth

Premature birth - delivery that began between 22 and 37 completed weeks of pregnancy; such a process can be early (22-27 weeks), middle (23-33 weeks) and late (33-37 weeks). The presence of infection in the fetus can provoke this pathology for 2 reasons:

any deviations in the development of the unborn child is a process that contradicts the basic law of nature about the survival of the fittest. The body of a woman often reacts violently to deviations of the unborn child caused by intrauterine infection, therefore she tries in every possible way to get rid of the defective fetus, and in this case a premature baby may be born;

when an unborn child is infected due to the fact that the pregnant woman has suffered an acute or chronic form of a sexually transmitted disease (syphilis, gonorrhea), premature birth can cause a violation of the muscle tone of the uterus or loss of elasticity

Diagnosis and treatment

Intrauterine infection of a child can only be assumed based on the combination of the following indicators:

data on specific diseases suffered by a pregnant woman at a certain stage of pregnancy;

the results of laboratory studies of the mother's physiological fluids, including amniotic fluid and a blood test for Torch infection (detection of rubella, herpes, cytomegalovirus, toxoplasma and pale spirochete viruses - the causative agent of syphilis);

ultrasound examination data that indicate pathologies of fetal development;

the results of the study of parts of the umbilical cord and placenta, as well as the blood and cerebrospinal fluid of the child (if the newborn is infected by contact).

Therapeutic tactics for various intrauterine infections are different and depend on the gestation period, the condition of the woman, the condition of the fetus, the nature and severity of the disease.

Intrauterine infection in a newborn is a special group of diseases that a baby becomes infected with even before birth. Cases of infection are also recorded directly during labor. Infections of this nature can lead to fetal death, miscarriage, or abnormal development.

Cases were recorded when pathologies led to early childbirth, defects, and severe damage to the central nervous system. That is why it is advisable to carry out diagnostics in a timely manner. It involves the implementation of research at the microscopic level. Additionally, functioning, immunity, enzymes, interaction of molecules and correctness in the work of biological processes are analyzed.

Treatment of infections of this nature is carried out with the help of immunoglobulins, modulators. A woman is prescribed regular intake of antiviral drugs, the action of which is aimed at destroying bacteria.

Intrauterine infection in newborns is observed in the presence of pathologies in certain processes. The situation is observed against the background of infection of the fetus. To date, it has not been possible to fully determine the route of infection. Today, about 10% of all children are born with this disease. This problem is especially acute in pediatrics, because of this, a large number of deaths and the development of diseases immediately after birth are recorded. Parents are advised to pay attention to the prevention of infection. In this case, it will be possible to reduce the risk of developing dangerous diseases.

The process of infection with these diseases begins even at the time the fetus is in the womb. The risk of infection also remains during labor. In this case, the carrier of the infection is the mother. The disease can be transmitted vertically or ascending. It all depends on the location of viruses and bacteria.

Only in rare cases, infection of a pregnant woman has been observed during diagnosis, which involved a biopsy or other specific procedures. The risk increases with the introduction of drugs to the baby through the blood, plasma.

Viral agents can be transmitted by the antenatal route. In this case, the fetus can be infected with rubella, herpes, hepatitis, HIV. Due to intracellular pathogens, toxoplasmosis or mycoplasmosis is diagnosed.

An important role is played by the state of the birth canal and the process of the birth of the baby. At this stage, there is a risk of microbes entering the baby's body in various ways. Among bacteria, the possibility of infection with streptococci, Proteus, Klebsiella and others is increased. The placenta is initially used as an effective barrier. However, even a slight damage to it can lead to the development of insufficiency. Through small holes, harmful bacteria can enter without any special obstacles. Among them, the syphilis virus is of particular danger.

The history of the mother and the presence of previously unfavorable pregnancies are also taken into account. The risk of intrauterine infections also increases if the baby was born prematurely. Additionally, the period in which the woman was infected (before and after the onset of pregnancy) is analyzed.

The child is directly affected by the period of infection, as well as the virus that caused the development of pathology. For example, if the pathogen got inside during the first ten weeks of pregnancy, then it will end in an independent miscarriage. If the infection occurred at the twelfth week, then most likely the child will be born dead or he will have serious malformations in the development of internal organs and systems. Infection of the fetus from the second trimester is fraught with abnormal development of individual internal organs or the presence of a pronounced generalized infection after birth.

It should be noted that the symptoms are radically different in mother and child. Even if no negative manifestations were found in a woman, serious lesions can subsequently be detected in the fetus.

The possibility of a stillbirth cannot be completely ruled out. Viruses and bacteria tend to penetrate deep into the tissue and disrupt the central nervous system, heart and other important organs.

The consequences of infection of the baby are visible even in the process of labor. The doctor pays attention to the condition of the amniotic fluid - they become cloudy, they contain a lot of meconium. The patient may feel unwell. If a child has an intrauterine infection, then the risk of having a baby with asphyxia, a large liver and other defects in general development increases. As a rule, rubella, pyoderma and various profuse skin rashes are additionally diagnosed. Some babies have fever, convulsions, various respiratory and cardiac disorders.

Antenatal intrauterine infection can lead to pneumonia, myocarditis, anemia and other diseases that appear within a few days after the baby is born. Next, the child is examined using special medical equipment. With its help, it is possible to identify diseases of the organs of vision, defects in the work of the heart, the presence of cysts and improper functioning of the brain.

The neonatologist pays attention to the baby in the postpartum period. In the presence of diseases, he often burps, there is muscle weakness, an incorrect reaction of the central nervous system. The skin is examined regularly. It is not allowed that it be a pronounced gray color. Intrauterine infections have a different incubation period. Each disease is analyzed separately depending on the nature and specification of manifestation.

Each individual TORCH infection has different methods of diagnosis and treatment. It is recommended to consult in detail with a specialist in this field.

Intrauterine infection is a broad concept. Its division is carried out depending on the source of the formation of the disease:

In medical practice, it is customary to combine the most common diseases with a special abbreviation - TORCH.

This syndrome includes toxoplasmosis, rubella, herpes and other lesions.

Including the study is carried out for the presence of HIV, hepatitis, smallpox, mycoplasmosis, syphilis.

The disease is diagnosed if the fetus in the womb was infected with Toxoplasma Gondii cells. Pathology can lead to abnormal development, the presence of malformations of the brain, heart and other internal organs.

Diagnosis is made immediately after the birth of the baby. The infection manifests itself in the form of severe fever, jaundice, swelling, stool disorders, and periodic convulsions. Additionally, the baby may have symptoms of meningitis and encephalitis. If the disease becomes chronic, then the situation is aggravated by strabismus or complete atrophy of the optic nerve. Unfortunately, the infection can be fatal before delivery.

At a late stage in the development of the disease, the baby develops epilepsy and complete blindness.

Infection is carried out in the case of the transfer of the disease during the period of gestation. In the first eight weeks, the probability reaches eighty percent. In the second trimester, it drops to twenty, and in the third - to eight percent.

If the child has a disease, he will be born prematurely and will not gain weight well. Additionally, a rash and obvious manifestations of jaundice can be seen on the skin.

Rubella of a congenital nature is dangerous by the manifestation of the following symptoms:

• partial or complete damage to the eye muscle;
• CHD (congenital heart defects);
• insufficient tone of the auditory nerve.

If the infection hit the baby in the second part of pregnancy, then he can be born with retinopathy or complete deafness.

Anomalies against the background of the transferred rubella are extensive. Defects can manifest themselves in the structure of the palate, hepatitis, abnormal structure of the skeleton or the genitourinary system. Infection is dangerous because the child may further lag behind in physical and mental development.

Cytomegaly: features of infection and the course of infection

This type of infection is dangerous because it leads to severe damage to the internal systems of a sick child. A complication can also lead to immunodeficiency or the appearance of purulent skin lesions. Defects can be either congenital or appear at a certain period of development. In the postpartum period, jaundice, hemorrhoids, pneumonia, anemia and other diseases may appear.

Subsequently, the organs of vision, liver, deafness and other diseases remain at risk.

Herpes infection can manifest itself in several forms:

• the generalized form is characterized by toxicosis, the presence of respiratory diseases, jaundice, diseases of the upper respiratory tract and lungs, hemorrhoids;
• neurological;
• damage to the mucous membrane and skin.

If the bacterial infection becomes multiple, then the child is diagnosed with sepsis.

Herpes is a dangerous infection that can lead to a number of complications. Among the most dangerous are complete deafness, blindness, abnormal development or lag in it.

Today, the diagnosis of intrauterine infections is quite acute. It is necessary to find out about the presence of harmful bacteria, viruses and fungi as early as possible. To do this, a smear is taken in the gynecologist's office, sowing for the presence of bacteria and the state of the microflora. In some cases, PCR or a complex TORCH analysis is additionally prescribed. Invasive prenatal diagnosis should be performed only for those women who are at high risk.

The gynecologist will also be able to consider certain markers during an ultrasound examination. Attention should be paid to diagnosis in the event that low or polyhydramnios and other pathologies of pregnancy development were previously diagnosed. If there are deviations, the doctor additionally prescribes a study of the features of the functioning of the heart and blood flow.

The study must be additionally carried out even after the birth of the baby. For this, microbiological tests are carried out. DNA research should be done. For this, serological research methods are used. An important role is played by the result of the histology of the placenta, which can also be performed after childbirth.

If the baby is suspected of having any intrauterine infection, then during the first day of life he should be constantly under the supervision of a neurologist, cardiologist and other specialists in the field of childhood diseases. At their discretion, tests are prescribed to identify pathologies in the development of hearing, vision and other internal organs.

At the first stage of eliminating pathologies, it is necessary to take drugs to increase immunity, against the development of viral, bacterial and other diseases.

To improve immunity, it is necessary to use special modulators and immunoglobulins. Acyclovir is most often used against viruses. Effective therapy against bacteria involves the use of broad-spectrum antibiotics.

Therapy must be carried out alternately to get rid of each individual symptom. Otherwise, the risk of pathologies in the work of the central nervous system increases. As a result, the child may experience problems in the work of the heart and lungs.

If a patient is diagnosed with a generalized form of the infection, then the probability of passing it on to her child is eighty percent. With local manifestations, the risk of damage to only individual internal organs increases. Unfortunately, almost every infection can lead to problems in the central nervous system in the future.

The main methods of prevention involve a complete examination of the patient before pregnancy. During gestation, you should protect yourself from contact with sick people. If a woman has not previously had rubella and has not been vaccinated against it, then an injection must be made three months before the planned pregnancy. Additionally, it should be noted that some cases of infection involve termination of pregnancy at any time.

Source: mladeni.ru

Intrauterine infection - causes, symptoms, consequences. Analysis for intrauterine infections

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. The signs and methods of diagnosing such diseases will be discussed in the article.

The danger of intrauterine infections is that they unceremoniously interfere in 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 the statistics say

1. A timely diagnosed and treated infectious disease in a pregnant woman poses a minimal danger to her child.
2. Infectious agents pass from mother to baby in 10 out of 100 pregnancies.
3. 0.5% of babies infected in the womb are born with the corresponding signs of the disease.
4. 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.
5. A number of infectious diseases that do not bode well for the baby may be present in the mother in a latent form and practically do not affect her well-being.
6. If a pregnant woman falls ill with one or another infectious disease for the first time, it is likely that the child will also become infected from it.

There are four ways that 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 pathogen rises to the uterus through the genital tract and, having penetrated into its cavity, infects the embryo. So the baby may have a chlamydial infection and enterococci;

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:

• gestational age 3 - 12 weeks: spontaneous abortion or the appearance of various developmental anomalies in the fetus;
• gestational age 11 - 28 weeks: the fetus noticeably lags behind in fetal development, the child is born with insufficient body weight and various malformations (for example, congenital heart disease);
• gestational age after 30 weeks: developmental anomalies affect the organs of the fetus, which by this time have already formed. The infection poses the greatest danger to the central nervous system, heart, liver, lungs and organs of vision.

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

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

Some time after childbirth, an acute intrauterine infection in newborns can manifest itself with the following signs:

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

If congenital infection is chronic, the clinical picture may be absent altogether. Distant signs of intrauterine infection are:

• complete or partial deafness;
• deviations in mental health;
• vision pathology;
• lagging behind peers in motor development.

The penetration of infection to the fetus through the uterus leads to the following consequences:

• the birth of a dead baby;
• intrauterine death of the embryo;
• frozen pregnancy;
• spontaneous abortion.

In children who survived such infection, the following pathological consequences are recorded:

• heat;
• rash and erosive skin lesions;
• non-immune dropsy of the fetus;
• anemia;
• enlarged liver on the background of jaundice;
• pneumonia;
• pathology of the heart muscle;
• pathology of the eye lens;
• microcephaly and hydrocephalus.

Every expectant mother is at risk of being captured by an infectious agent, because during pregnancy the defenses of her body are exhausted to the limit. But the greatest danger lies in wait for women who:

• already have one or more children attending kindergarten, school;
• are related to the field of medicine and are in direct contact with people who may be potential carriers of the infection;
• work in a kindergarten, school and other children's institutions;
• have had 2 or more medical abortions in the past;
• have inflammatory diseases in a sluggish form;
• faced with an untimely rupture of amniotic fluid;
• have had a pregnancy in the past with abnormal development of the embryo 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 distinguish several universal signs by which it can be assumed that the expectant mother has contracted an infectious disease:

• a sharp increase in temperature, fever;
• shortness of breath when walking or climbing stairs;
• cough;
• rash on the body;
• enlarged lymph nodes, painfully responsive to touch;
• sore joints that look swollen
• conjunctivitis, lacrimation;
• nasal congestion;
• pain in the chest.

Such a set of indications may also indicate the development of an allergy in a pregnant woman. In this case, there is no threat of 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, getting into 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 condition of the child appears if only a pregnant woman has a high body temperature.

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

1. Acute and chronic diseases of the mother in the genitourinary system. Among them are such inflammatory pathologies as cervical ectopia, urethritis, cystitis, pyelonephritis.
2. The mother is immunocompromised or HIV-infected.
3. Transplantation of organs and tissues that a woman has undergone in the past.

Intrauterine infections: main characteristics and ways of infection

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, when transfused from an infected donor).

With the primary infection of a woman in position, the microorganism penetrates the placenta and infects the fetus. In some cases, no abnormal consequences after infection in the baby are observed. But at the same time, statistics say: 10 babies out of 100, 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;
• the birth of a dead baby;
• hearing loss of neurosensory origin;
• low birth weight;
• hydro- and microcephaly;
• pneumonia;
• lag in the development of psychomotor;
• 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 children die within 2 to 3 months after birth. In addition, the development of such consequences as mental retardation, hearing loss and blindness is likely. With a slight local lesion, the consequences are not so fatal.

Unfortunately, there are no drugs yet that can eliminate the symptoms of CMV in newborns. If a woman in a position has been diagnosed with cytomegalovirus infection, the pregnancy is left, because the child has a chance to stay healthy. The expectant mother will be prescribed an appropriate course of treatment in order to smooth out the effect of the disease on her body as much as possible.

A newborn baby is diagnosed with a congenital herpes infection if his mother has herpes simplex virus type 2, which in most cases is infected 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 childbirth, when it moves through the birth canal of an infected mother. In some cases, the virus enters the fetus through the placenta.

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

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

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

Herpes simplex virus under the microscope

This disease is rightfully considered one of the most dangerous for the life of the embryo. The route of transmission of the rubella virus is airborne, and infection is possible even at a great 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 in the development of the heart muscle;
• hearing loss;
• cataract;
• various skin diseases;
• pneumonia;
• unnatural enlargement of the liver and spleen;
• meningitis, encephalitis.

The presence of this virus in the body provokes the development of a disease known as infectious erythema. In adults, the disease does not manifest itself in any way, since it proceeds latently. 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 gestation, the fetus is especially defenseless against this infection.

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

• puffiness;
• anemia;
• brain damage;
• hepatitis;
• inflammation of the myocardium;
• peritonitis.

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

Congenital chickenpox is identified by the following features:

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

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

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 enters 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 is treatable with the appropriate approach;
• oncological diseases of the liver;
• sluggish form of hepatitis B;
• an acute form of hepatitis B, which provokes the development of liver failure in a 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 specific immune lymphocytes. In most cases, infection occurs during sexual intercourse with a sick partner. A child can become infected while in the womb, or already during childbirth. HIV-infected children are shown intensive complex treatment, otherwise they will not live even two years - the infection quickly "eats" a weak organism. Infected children die from infections that do not pose a mortal danger to healthy babies.

To confirm HIV in an infant, a polymerase chain reaction diagnostic method is used. It is also very important to timely 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.

The disease develops as a result of the vital activity of the Listeria bacterium. The microorganism easily penetrates to the fetus through the placenta. Infection of a pregnant woman occurs through unwashed vegetables and a number of food products (milk, eggs, meat). In a woman, 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;
• brain inflammation;
• refusal of food;
• sepsis;
• spontaneous miscarriage;
• the birth of a dead baby.

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

If a woman in position 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 the survivors are diagnosed with congenital syphilis. The child will become infected even if the disease is latent in the mother. The results of the activity 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;
• the formation of cracks and rashes on the skin;
• anemia;
• jaundice;
• lag in mental development;
• premature birth;
• stillbirth.

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 her 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 crumbs - in 50 cases out of 100, the infection overcomes the placental barrier and affects the fetus. The consequences of infection of the child are as follows:

• damage to the organs of vision;
• hydrocephalus;
• microcephaly;
• abnormally enlarged liver and spleen;
• brain inflammation;
• 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 take tests that help identify these pathological conditions.

Within 9 months, the expectant mother will have to undergo more than one laboratory test so that the doctors make sure that she is healthy. Women in position take a blood test for hepatitis B and C, syphilis. In relation to pregnant women, the PRC method is also practiced, 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 smear from the vagina for microflora.

Ultrasound is essential 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, doctors can use it to detect abnormalities in fetal development caused by pathogenic microorganisms. There is every reason to talk about intrauterine infection if the following symptoms become apparent on ultrasound:

1. Formed pathologies of development.
2. Polyhydramnios or oligohydramnios.
3. Edema of the placenta.
4. An enlarged abdomen and unnaturally enlarged structural units of the kidneys.
5. Enlarged internal organs: heart, liver, spleen.
6. Foci of calcium deposition in the intestines, liver and brain.
7. Enlarged ventricles of the brain.

In the diagnostic program for examining expectant mothers belonging to the risk groups that we talked about above, a special place is occupied by the seroimmunological method for determining immunoglobulins. As needed, doctors resort to amniocentesis and cordocentesis. The first method of research is to study amniotic fluid, the second involves the study of cord blood. These diagnostic methods are very informative in detecting infection. If the presence of an intrauterine infection is suspected in an infant, then the biological fluids of the baby, for example, saliva or blood, serve as the material for the study.

Carrying a child, a woman tries to protect him from adverse external influences. The health of a developing baby is the most important thing during this period, all protective mechanisms are aimed at preserving it. But there are situations when the body cannot cope, and the fetus is affected in utero - most often it is an infection. Why it develops, how it manifests itself and what risks it carries for the child - these are the main questions that concern expectant mothers.

In order for an infection to appear, including intrauterine, the presence of several points is necessary: ​​the pathogen, the route of transmission and the susceptible organism. Microbes are considered the direct cause of the disease. The list of possible pathogens is very wide and includes various representatives - bacteria, viruses, fungi and protozoa. It should be noted that intrauterine infection is mainly due to microbial associations, that is, it has a mixed character, but monoinfections are not uncommon. Among the common pathogens, it is worth noting the following:

1. Bacteria: staphylo-, strepto- and enterococci, E. coli, Klebsiella, Proteus.
2. Viruses: herpes, rubella, hepatitis B, HIV.
3. Intracellular agents: chlamydia, mycoplasma, ureaplasma.
4. Fungi: candida.
5. The simplest: toxoplasma.

Separately, a group of infections was identified that, despite all the differences in morphology and biological properties, cause similar symptoms and are associated with persistent developmental defects in the fetus. They are known by the abbreviation TORCH: toxoplasma, rubella, cytomegalovirus, herpes and others. It should also be said that in recent years there have been certain changes in the structure of intrauterine infections, which is associated with the improvement of diagnostic methods and the identification of new pathogens (for example, listeria).

The infection can enter the child in several ways: through the blood (hematogenous or transplacental), amniotic fluid (amniotic), the mother's genital tract (ascending), from the uterine wall (transmural), through the fallopian tubes (descending) and with direct contact. Accordingly, there are certain risk factors for infection that a woman and a doctor should be aware of:

• Inflammatory pathology of the gynecological sphere (colpitis, cervicitis, bacterial vaginosis, adnexitis, endometritis).
• Invasive interventions during pregnancy and childbirth (amnio- or cordocentesis, chorionic biopsy, caesarean section).
• Abortions and complications in the postpartum period (earlier transferred).
• Insufficiency of the cervix.
• Polyhydramnios.
• Fetoplacental insufficiency.
• General infectious diseases.
• Foci of chronic inflammation.
• Early onset of sexual activity and promiscuity in sexual relations.

In addition, many infections are characterized by a latent course, undergoing reactivation in violation of metabolic and hormonal processes in the female body: hypovitaminosis, anemia, heavy physical exertion, psycho-emotional stress, endocrine disorders, exacerbation of chronic diseases. Those who have identified such factors are at high risk of intrauterine infection of the fetus. He also shows regular monitoring of the condition and preventive measures aimed at minimizing the likelihood of developing pathology and its consequences.

Intrauterine infection develops when infected with microbes, which is facilitated by many factors from the maternal organism.

The degree of pathological impact is determined by the characteristics of the morphological development of the fetus at a particular stage of pregnancy, its reaction to the infectious process (maturity of the immune system), and the duration of microbial aggression. The severity and nature of the lesion is not always strictly proportional to the virulence of the pathogen (the degree of its pathogenicity). Often a latent infection caused by chlamydial, viral or fungal agents leads to intrauterine death or the birth of a child with serious abnormalities. This is due to the biological tropism of microbes, i.e., the tendency to reproduce in embryonic tissues.

Infectious agents have different effects on the fetus. They can provoke an inflammatory process in various organs with the further development of a morphofunctional defect or have a direct teratogenic effect with the appearance of structural anomalies and malformations. Equally important are the intoxication of the fetus with products of microbial metabolism, disorders of metabolic processes and hemocirculation with hypoxia. As a result, the development of the fetus suffers and the differentiation of internal organs is disturbed.

The clinical manifestations and severity of the infection are determined by many factors: the type and characteristics of the pathogen, the mechanism of its transmission, the intensity of the immune system and the stage of the pathological process in the pregnant woman, the gestational age at which the infection occurred. In general terms, this can be represented as follows (table):

Symptoms of intrauterine infection are noticeable immediately after birth or in the first 3 days. But it should be remembered that some diseases may have a longer incubation (latent) period or, conversely, appear earlier (for example, in premature babies). Most often, the pathology is manifested by the infection syndrome of the newborn, manifested by the following symptoms:

• Decreased reflexes.
• Muscle hypotension.
• Refusal to feed.
• Frequent vomiting.
• Pale skin with periods of cyanosis.
• Change in the rhythm and frequency of breathing.
• Muffled heart sounds.

Specific manifestations of pathology include a wide range of disorders. Based on the tissue tropism of the pathogen, intrauterine infection during pregnancy can manifest itself:

1. Vesiculopustulosis: rash on the skin in the form of vesicles and pustules.
2. Conjunctivitis, otitis and rhinitis.
3. Pneumonia: shortness of breath, cyanosis of the skin, wheezing in the lungs.
4. Enterocolitis: diarrhea, bloating, sluggish sucking, regurgitation.
5. Meningitis and encephalitis: weak reflexes, vomiting, hydrocephalus.

Along with a local pathological process, the disease can be widespread - in the form of sepsis. However, its diagnosis in newborns is difficult, which is associated with the low immune reactivity of the child's body. At first, the clinic is rather poor, since there are only symptoms of general intoxication, including those already listed above. In addition, the baby has a lack of body weight, the umbilical wound does not heal well, jaundice appears, the liver and spleen increase (hepatosplenomegaly).

In children infected in the prenatal period, disturbances are detected in many vital systems, including the nervous, cardiovascular, respiratory, humoral, and immune systems. Key adaptive mechanisms are violated, which is manifested by hypoxic syndrome, malnutrition, cerebral and metabolic disorders.

The clinical picture of intrauterine infections is very diverse - it includes specific and general signs.

Most children infected with cytomegalovirus have no visible abnormalities at birth. But in the future, signs of neurological disorders are revealed: deafness, slowing down of neuropsychic development (mild mental retardation). Unfortunately, these disorders are irreversible. They may progress with the development of cerebral palsy or epilepsy. In addition, a congenital infection can manifest itself:

• Hepatitis.
• Pneumonia.
• hemolytic anemia.
• thrombocytopenia.

These disorders disappear over a certain period even without treatment. Chorioretinopathy may occur, which is rarely accompanied by decreased vision. Severe and life-threatening conditions are very rare.

The greatest danger to the fetus is a primary genital infection in the mother or an exacerbation of a chronic disease. Then the child becomes infected by contact, passing during childbirth through the affected genital tract. Intrauterine infection is less common, it occurs before the natural end of pregnancy, when the fetal bladder bursts, or at other times - from the first to the third trimester.

Infection of the fetus in the first months of pregnancy is accompanied by heart defects, hydrocephalus, anomalies of the digestive system, intrauterine growth retardation, and spontaneous abortions. In the second and third trimesters, pathology leads to the following abnormalities:

• anemia.
• Jaundice.
• Hypotrophy.
• Meningoencephalitis.
• Hepatosplenomegaly.

And herpes infection in newborns is diagnosed by bubble (vesicular) lesions of the skin and mucous membranes, chorioretinitis and encephalitis. There are also common forms, when several systems and organs are involved in the pathological process.

A child can become infected from the mother at any stage of pregnancy, and clinical manifestations will also depend on the time of infection. The disease is accompanied by damage to the placenta and fetus, intrauterine death of the latter, or does not give any consequences at all. Children born with an infection are characterized by rather specific anomalies:

But in addition to these signs, other structural abnormalities may occur, for example, microcephaly, "cleft palate", disorders of the skeleton, genitourinary system, hepatitis, pneumonia. But in many children born infected, no pathology is detected, and problems begin in the first five years of life - hearing deteriorates, psychomotor development slows down, autism and diabetes mellitus appear.

Rubella has a clear teratogenic effect on the fetus, leading to various anomalies, or provokes its death (spontaneous abortion).

Infection with toxoplasmosis in early pregnancy can be accompanied by severe consequences for the fetus. Intrauterine infection provokes the death of a child or the occurrence of multiple anomalies in him, including hydrocephalus, brain cysts, edematous syndrome, and destruction of internal organs. A congenital disease is often widespread, manifesting itself with the following symptoms:

• anemia.
• Hepatosplenomegaly.
• Jaundice.
• Lymphadenopathy (enlarged lymph nodes).
• Fever.
• Chorioretinitis.

When infected at a later date, the clinical manifestations are rather poor and are mainly characterized by a decrease in vision or unexpressed disorders in the nervous system, which often remain undetected.

Prenatal diagnosis of infectious lesions of the fetus is of great importance. To determine the pathology, laboratory and instrumental methods are used to identify the pathogen and identify deviations in the development of the child at various stages of pregnancy. If intrauterine infection is suspected, perform:

1. Biochemical blood test (antibodies or microbial antigens).
2. Analysis of smears from the genital tract and amniotic fluid (microscopy, bacteriology and virology).
3. Genetic identification (PCR).
4. Ultrasound (fetometry, placentography, dopplerography).
5. Cardiotocography.

After birth, newborns are examined (skin swabs, blood tests) and the placenta (histological examination). Comprehensive diagnostics allows you to identify pathology at the preclinical stage and plan further treatment. The nature of the activities carried out will be determined by the type of infection, its spread and the clinical picture. Prenatal prevention and proper management of pregnancy also play an important role.

Intrauterine infections - symptoms, treatment, forms, stages, diagnosis

Intrauterine infection (IUI) is understood as infectious and inflammatory diseases of the fetus and young children that occur in the antenatal (prenatal) and (or) intranatal (proper birth) periods with vertical infection from the mother.

It is necessary to distinguish between the concepts of "intrauterine infection" and "intrauterine infection". Infection implies the penetration of the pathogen into the child's body without the development of a clinical picture, while intrauterine infection is a full-fledged realization of intrauterine infection in the form of a clinical manifestation of an infectious disease.

According to the results of some studies, infection is detected in approximately 50% of full-term and 70% of premature babies. According to more "optimistic" data, every tenth fetus (child) is exposed to pathogens during pregnancy and childbirth.

In 80% of cases, IUI complicates the health of the child with a variety of pathological conditions and malformations of varying severity. According to the results of autopsy, it is determined that in every third case, perinatal infection was the main cause of the death of a newborn, accompanied or complicated the course of the underlying disease.

Long-term studies show that children of the first years of life who have had an intrauterine infection have weaker immune capabilities and are more susceptible to infectious and somatic diseases.

In the early 70s of the XX century, the World Health Organization proposed the name "TORCH syndrome". This abbreviation reflects the names of the most common intrauterine infections: T - toxoplasmosis (Toxoplasmosis), O - others (mycoplasma, syphilis, hepatitis, streptococci, candida, etc.) (Other), R - rubella (Rubella), C - cytomegalovirus (Cytomegalovirus), H - herpes (Herpes). If the etiological factor is not known for certain, they speak of TORCH syndrome.

The main source of infection in IUI, as already noted, is the mother, from which the pathogen enters the fetus in the ante- and (or) intranatal period (vertical transmission mechanism).

The causative agents of intrauterine infection can be bacteria, fungi, protozoa, viruses. According to statistical data, bacterial diseases occupy the first place in the structure of intrauterine infections (28%), and chlamydial and associated infections are in second place (21%).

Infectious agents, the most common causes of intrauterine infection:

• rubella viruses, herpes simplex, chicken pox, hepatitis B and C, influenza, adenoviruses, enteroviruses, cytomegalovirus;
• pathogenic bacteria (escherichia, klebsiella, proteus and other coliform bacteria, group B streptococci, Haemophylus influenzae, alpha-hemolytic streptococci, non-spore-forming anaerobes);
• intracellular pathogens (toxoplasma, mycoplasma, chlamydia);
• mushrooms of the genus Candida.

Risk factors for intrauterine infection:

• chronic diseases of the urogenital area in the mother (erosive lesions of the cervix, endocervicitis, colpitis, vulvovaginitis, ovarian cyst, urethritis, cystitis, pyelo- and glomerulonephritis, etc.);
• infectious diseases suffered by the mother during pregnancy;
• long dry period.

Factors indirectly indicating a possible intrauterine infection:

• aggravated obstetric history (spontaneous abortion, infertility, stillbirth, birth of children with multiple malformations);
• polyhydramnios, the presence of inclusions and impurities in the amniotic fluid;
• fever, not accompanied by signs of inflammation in any organ system, developed in the mother during pregnancy or childbirth;
• the birth of a premature baby before the due date of birth;
• delayed intrauterine development of the child;
• Apgar score 0-4 points at the 1st minute of a child's life with unsatisfactory performance or worsening of the score by the 5th minute of life;
• fever of the newborn of unknown etiology.

Depending on the gestational age at which infection occurred, there are:

• blastopathy - are realized during the first 14 days of pregnancy;
• embryopathies - appear in the period from 15 days of pregnancy to 8 weeks;
• fetopathy - develop after 9 weeks of pregnancy (early fetopathy - from the 76th to the 180th day of pregnancy, late fetopathy - from the 181st day of pregnancy until the moment of delivery).

An intrauterine infection that develops in the first 2 weeks of pregnancy most often leads to the death of the fetus (missed pregnancy) or the formation of severe systemic malformations similar to genetic developmental anomalies. Spontaneous abortion, as a rule, occurs after 2-3 weeks from the moment of infection.

Since the laying of all organs and systems is carried out in the embryonic period, the development of IUI at these times will lead to the death of the embryo or, as in the previous case, to the formation of malformations of varying severity.

Fetopathies have a number of characteristics:

• congenital malformations are realized only in those organs, the formation of which was not completed at the time of the birth of the child;
• infectious processes are more often generalized (common) in nature;
• infection is often accompanied by the development of thrombohemorrhagic syndrome;
• morphological and functional maturation of organs occurs with a lag.

The World Health Organization (ICD-10) has proposed an extensive classification of intrauterine infections, the main forms of which are:

Often, intrauterine infections do not have characteristic symptoms, therefore, non-specific signs of an infectious and inflammatory process in a newborn allow suspecting their presence (their similarity was noted in IUI provoked by various pathogens):

• decrease or lack of appetite;
• significant weight loss (weight loss of more than 10% of the initial weight at birth);
• repeated weight loss, poor weight recovery (slow gain, slight gains);
• inflammation of the skin and subcutaneous fat (sclerema);
• lethargy, drowsiness, apathy;
• grayish-pale staining of the skin, anemic mucous membranes, icteric staining of the skin and mucous membranes, scleral icterus;
• edematous syndrome of varying severity and localization;
• respiratory disorders (shortness of breath, short-term episodes of respiratory arrest, involvement of auxiliary muscles in the act of breathing);
• dyspeptic disorders (regurgitation, including profuse, fountain, unstable stool, enlargement of the liver and spleen);
• symptoms of involvement of the cardiovascular system (tachycardia, lowering blood pressure, swelling or pastosity, cyanotic staining of the skin and mucous membranes, marbling of the skin, cold extremities);
• neurological symptoms (hyper- or hypotension, dystonia, decreased reflexes (including worsening of the sucking reflex);
• changes in the blood formula (leukocytosis, accelerated ESR, anemia, a decrease in the number of platelets).

Signs of intrauterine infection often manifest in the first 3 days of a newborn's life.

When diagnosing IUI, the data of anamnesis, laboratory and instrumental research methods are taken into account:

• complete blood count (leukocytosis with a neutrophilic shift to the left, accelerated ESR are detected);
• biochemical blood test (for markers of the acute phase reaction - C-reactive protein, haptoglobin, ceruloplasmin, plasminogen, alpha-1-antitrypsin, antithrombin III, complement C3 fraction, etc.);
• classical microbiological methods (virological, bacteriological);
• polymerase chain reaction (PCR);
• direct immunofluorescence method using monoclonal antibodies;
• enzyme immunoassay (ELISA) with the quantitative determination of specific antibodies of the IgM, IgG classes;
• Ultrasound of the abdominal organs, heart, brain.

Treatment of intrauterine infection is complex, consists of etiotropic and symptomatic components:

Pregnancy outcomes in IUI:

• intrauterine fetal death;
• stillbirth;
• the birth of a live viable or live non-viable (with malformations incompatible with life) child with signs of intrauterine infection.

Complications of intrauterine infection:

• malformations of internal organs;
• secondary immunodeficiency;
• lagging behind the child from peers in physical and mental development.

With timely diagnosis and complex treatment of intrauterine infection that occurred in the later stages, the prognosis is generally favorable (the prognosis improves as the gestational age at which infection occurred increases), although it is purely individual.

The probability of a favorable outcome of the disease depends on many characteristics: the virulence of the pathogen, its type, the method of infection, the presence of concomitant pathology and aggravating factors on the part of the mother, the functional state of the body of the pregnant woman, etc.

When IUI occurs in the early stages, the prognosis is usually unfavorable.

Prevention of the development of IUI is as follows:

• prevention of infectious diseases of the mother (sanation of foci of chronic inflammation, timely vaccination, screening of pregnant women for the presence of TORCH infections);
• antibacterial or antiviral therapy in pregnant women with the development of acute or exacerbation of chronic infectious inflammation;
• examination of newborns from mothers from high-risk groups;
• early vaccination of newborns.

Video from YouTube on the topic of the article:

At present, a paradoxical situation has arisen in the Russian Federation, when the emerging trend towards an increase in the birth rate and a decrease in perinatal mortality is combined with a deterioration in the quality of newborn health, an increase in the proportion of congenital malformations and infectious diseases among the causes of infant mortality. The high infection of the adult population with viruses, protozoa and bacteria determines the significant prevalence of intrauterine infections in newborns. The source of infection for the fetus is always the mother. The pathogen can enter the fetus antenatally and intranatally; This penetration can result in two clinical situations, called "intrauterine infection" and "intrauterine infection". These concepts are not identical.

Intrauterine infection should be understood as the alleged fact of intrauterine penetration of microorganisms to the fetus, in which no signs of an infectious disease of the fetus are detected.

Intrauterine infection should be understood as the established fact of intrauterine penetration of microorganisms to the fetus, in which pathophysiological changes characteristic of an infectious disease occurred in the body of the fetus and / or newborn, detected prenatally or shortly after birth.

Most cases of suspected intrauterine infection are not accompanied by the development of an infectious disease. The frequency of clinical manifestations of intrauterine infection in a newborn depends on the properties of the microorganism, the ways and timing of its transmission from the pregnant woman to the fetus and averages about 10% of all cases of intrauterine infection (ranging from 5% to 50%).

The high-risk group for intrauterine infection is: pregnant women with obstetric pathology (threatened miscarriage, miscarriage, premature birth, non-developing pregnancy, antenatal death and fetal abnormalities); women who have had acute infections during pregnancy, who have foci of chronic infection, especially in the urogenital area, as well as those who have had infectious complications in the early postpartum period.

Risk factors for intranatal infection are a long anhydrous period, the presence of meconium in the amniotic fluid, fever during childbirth in the mother, the birth of a child in asphyxia, which required the use of artificial lung ventilation.

The clinical picture of intrauterine infection in a newborn depends on a number of factors. Of great importance is the fact of the primary disease of the mother during pregnancy, when the primary immune response is significantly reduced. In this case, as a rule, a severe, often generalized form of the disease develops; the causative agent penetrates to the fetus transplacentally. If a pregnant woman has immunity to infection, then intrauterine infection or a mild form of the disease is possible.

The clinic of intrauterine infection in a newborn is significantly affected by the period of penetration of the infectious agent to the fetus. In the case of viral infection of the fetus in the embryonic period of development, antenatal death or multiple malformations are observed. At 3-5 months of intrauterine life, infectious fetopathy develops, characterized by a decrease in fetal body weight, tissue malformations, immaturity of the central nervous system, lungs, kidneys, and dystrophic disorders in the cells of parenchymal organs. If a fetal infection occurs in the II-III trimesters of pregnancy, both signs of an infectious lesion of individual organs (hepatitis, myocarditis, meningitis, meningoencephalitis, chorioretinitis, etc.) and symptoms of a generalized infection can be detected.

Clinical manifestations of intrauterine infection also depend on the route of penetration of the infectious agent to the fetus. Distinguish:

1) hematogenous (transplacental) route of penetration; as a rule, it gives the development of a severe, generalized form of the disease and is characterized by severe jaundice, hepatitis, multiple organ damage;

2) ascending route of infection - more often with urogenital infection in the mother (for example, chlamydia); the pathogen enters the uterine cavity, affects the membranes of the fetus, enters the amniotic fluid; the newborn develops conjunctivitis, dermatitis, lesions of the gastrointestinal tract, pneumonia, and generalization of the process is possible;

3) descending route of infection - the infectious agent penetrates through the fallopian tubes, and then - as with the ascending route of infection;

4) contact route - in the process of birth, through the natural birth canal, for example, with genital herpes, candidal colpitis; the disease in a newborn develops as a lesion of the skin and / or mucous membranes, although later it can also be generalized.

The most typical symptoms of intrauterine infection detected in the early neonatal period are intrauterine growth retardation, hepatosplenomegaly, jaundice, rash, respiratory distress, cardiovascular failure, and severe neurological impairment. Given that the combination of the above symptoms occurs with intrauterine infections of various etiologies, the term “TORCH syndrome” is used in the English literature to refer to the clinical manifestations of intrauterine infection. In this abbreviation, under “T” stands for toxoplasmosis (toxoplasmosis), under “R” - rubella (rubella), under “C” - cytomegaly (cytomegalia), under “H” - herpes infection (herpes infectio), under “O” - other infections (other). “Other infections” that manifest themselves in the neonatal period with TORCH syndrome currently include syphilis, listeriosis, viral hepatitis, chicken pox, etc.

In recent years, there has been a trend towards an increase in the frequency of mixed viral-viral and viral-bacterial infections.

All newborns with typical manifestations of intrauterine infection, as well as children at high risk, in case of deterioration in their condition in the early neonatal period, should undergo a targeted laboratory examination for TORCH infection in order to establish or objectively confirm the etiology of the disease.

The diagnosis of intrauterine infection is always clinical and laboratory. The absence of clinical manifestations of an infectious disease in the perinatal period in most cases makes laboratory testing for TORCH infection inappropriate. An exception may be a planned examination of clinically healthy newborns from mothers with tuberculosis, syphilis and genital herpes (in case of its exacerbation shortly before delivery).

According to the ability to identify the causative agent of infection, laboratory diagnostic methods can be divided into two groups: direct, which allow to detect viruses or microorganisms in the biological fluids or tissues of the child (fetus), and indirect, which allow to register the specific immune response of the child (fetus) to viruses or microorganisms.

Direct methods include:

• Microscopy (electronic or direct, e.g. dark field)
• Detection of viral or bacterial antigens (including single-stage enzyme immunoassay and immunochromatographic methods)
• Polymerase chain reaction (PCR)
• cultural method.

Direct laboratory diagnostic methods can detect the presence of the pathogen in biological fluids or tissue biopsies of an infected child. However, their sensitivity and specificity significantly depend on the type of pathogen being detected, the quality of laboratory equipment and reagents. Therefore, the results of a child's examination conducted in different clinical and research laboratories may be different.

Despite the fact that in recent years the PCR method has been rapidly developing as a highly sensitive and specific method, the “gold standard” for diagnosing all bacterial and a number of viral infections (including rubella and herpes) is the cultural method. To date, the most reliable method for diagnosing syphilis is the detection of treponemal antigen by the immune fluorescence reaction and the immobilization reaction of pale treponema.

Indirect (indirect) methods include the so-called serological methods, of which the most informative is the enzyme immunoassay method for determining specific IgG, IgM, IgA (ELISA). The sensitivity and specificity of serological methods for detecting infections in newborns is significantly worse than in older children and adults, which is associated with the characteristics of the immune response and the presence of maternal antibodies in their blood. However, from a technical point of view, these methods are quite simple, which makes it possible to use them for primary screening for intrauterine infection.

When using serological diagnostic methods, remember:

1) the examination must be carried out before the use of donor blood products in the treatment of the child;

2) the results of the examination of the child must always be compared with the results of the examination of the mother;

3) the presence of specific immunoglobulins of the IgG class in a titer equal to or less than the titer of the corresponding maternal antibodies indicates not an intrauterine infection, but a transplacental transfer of maternal antibodies;

4) the presence of specific immunoglobulins of the IgM class in any titer indicates the primary immune response of the fetus or newborn to the corresponding bacterial / viral antigen and may be an indirect sign of infection;

5) the absence of specific immunoglobulins of the IgM class in the blood serum of newborns in a number of diseases (including neonatal herpes) does not exclude the possibility of intrauterine (intranatal) infection.

Of particular interest in the diagnostic plan is the study of the pathomorphology of the placenta, fetal membranes and umbilical cord of newborns, which allows early diagnosis of various infectious and inflammatory processes.

In the process of laboratory examination of newborns with TORCH syndrome who are in critical condition, it is first necessary to identify (exclude) diseases that can be prevented and treated specifically (hepatitis B, herpes infection, toxoplasmosis, listeriosis, chlamydia, syphilis).

Pregnant women are subject 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 still copes, the spread of infection does not occur, but during gestation, there is not enough strength for this.

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

For a child, the source of infection is always the mother's body. However, if a woman suffers some kind of disease during gestation, 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), there are groups:

• bacterial: most often it is E. coli, strepto- and staphylococcus and others;
• viral: influenza, SARS, enterovirus infections, HIV, etc.;

The most common group is the TORCH complex, which includes: toxoplasmosis, rubella, cytomegalovirus, herpes virus of the first and second type, some other infections.

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

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

Symptoms of intrauterine infection during gestation:

• polyhydramnios or oligohydramnios according to the results of ultrasound;
• delayed fetal development;

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

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

• congenital pneumonia;
• inflammation of the umbilical wound - omphalitis;
• conjunctivitis;
• sepsis;
• decrease in hemoglobin level;

Factors affecting 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 at which the woman suffered the infection. In the early days, the relationship between the chorion and the mother's body is not as close as later. Therefore, the likelihood of spreading inflammation to the baby is less. As the gestation period increases, the relationship is so close that almost any infection spreads to both.
• maternal immunity. Dangerous primary infection during pregnancy. 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:

• passes on its own, with virtually no consequences for the health of the baby;

An approximate set of tests to detect infection:

• . Helps to 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 for the child. Class G immunoglobulins appear after immunity is formed to the microbe, they circulate in the blood all their lives. The doctor's task is to determine exactly when, before or during pregnancy.
• Bacteriological culture. For research, any material can be taken, depending on where the source of infection is supposed to be. Most often, a bacteriological examination is performed of the discharge from the genital tract (vagina and cervix), urine, the contents of the rectal mucosa, oral cavity, nose, and pharynx.
• Detection of overt pathogens (eg chlamydia, mycoplasma, etc.) or an excess of opportunistic pathogens (causing active infection only when large numbers are present) by more than 104 is an indication for active treatment.
• PCR. Helps to detect a pathogen even if its quantity is measured in units. For research, any biological fluid can be taken.

• ultrasound can identify indirect signs of involvement in the process of the placenta and the child (for example, edema of the "children's place", thickening of the walls, impaired blood flow, fetal growth retardation, malformations, etc.), evaluate the effectiveness of treatment and exclude other diseases.

After childbirth, to confirm intrauterine infection for crops and PCR, the baby's biological discharge is taken, 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. They are prescribed if a bacterial infection, STIs are suspected (for example, chlamydia, ureaplasma, mycoplasma were found in the genital tract, in crops - a high amount of Escherichia coli, streptococcus, etc.). The choice of drug is determined by the sensitivity of microbes to it, which is indicated during sowing. In some cases, broad-spectrum antibiotics may be prescribed. The gestational age and potential risks are also taken into account.
• Antivirals

• 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 during pregnancy with sick people, to avoid crowded places, especially children.
• Examination for TORCH-complex in the absence of immunity, drawing up separate recommendations. For example, if a girl has never had rubella, you should be vaccinated against this infection and protect yourself from infection during pregnancy. In the absence of antibodies to toxoplasmosis, it is recommended to abandon the introduction of cats, as they are carriers of toxoplasmosis.

Read more in our article on intrauterine infections.

Read in this article

Causes of intrauterine infection of the fetus

In ordinary life, a woman's body is constantly faced with many bacteria and viruses. A good immune system allows you to meet microbes, remember them and thus 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), protection from obvious pathogens.

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

Pregnancy is a condition in which there is a change in the work of all parts of the immune system. This is necessary for the normal bearing of the fetus, which is half foreign to the woman's body. The balance of beneficial and pathogenic microbes can be disturbed. Therefore, pregnant women are prone 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 still copes, the spread of infection does not occur, but during gestation, there is not enough strength for this.
• They often catch various infections, to which they were normally resistant. Influenza, colds and other similar diseases are, as a rule, more difficult and with a large number of consequences for the body of a woman and a child.

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

• exacerbation of chronic foci of inflammation in the mother; pathogens easily cross the placenta to the baby, especially in the second or third trimester;
• infection during pregnancy; viruses and bacteria in various ways can get into the tissues of the placenta, amniotic fluid and to the baby.

Pathways for the penetration of pathogens to the baby are as follows:

• transplacental: can be hematogenous (with the mother's blood) and lymphogenous (through the lymphatic vessels);
• ascending: through the cervix into deeper tissues, as a rule, sexual 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 gestation, 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, it is E. coli, strepto- and staphylococcus and others;
• viral: influenza, SARS, enterovirus infection, HIV, etc.;
• fungal and caused by protozoa.

They also distinguish 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 of the first and second type;
• some other infections.

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

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

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

Watch this video about the most dangerous infections during pregnancy:

Symptoms during pregnancy

The danger of intrauterine infection during pregnancy lies in the fact 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 has 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 gestation, you can talk about intrauterine infection if you have the following symptoms:

• threat of interruption up to 37 weeks: pulling pains in the lower abdomen, detection of hematomas and areas of detachment by ultrasound, bleeding;
• or oligohydramnios on ultrasound;
• delayed fetal development;
• other signs on ultrasound, for example, the detection of "flakes" in the amniotic fluid, impaired 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 tissues, 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 that does not respond well to standard treatment;
• decrease in hemoglobin level;
• hemorrhages in the internal organs and brain;
• low birth weight;
• congenital malformations: cataracts, glaucoma, disorders in the structure of the heart, brain, and many others.

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

Consequences for the newborn

That, what will be the consequences of the transferred intrauterine infection for the baby, it is difficult to say right away. It all depends on:

• The 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 spreading inflammation to the baby is less than with the transplacental route of transmission. As the gestation period increases, the connection in the mother-placenta-fetus system is so close that almost any infection spreads to both.
• maternal immunity. If a woman has previously met with an infectious agent, she already had a primary response to the pathogen, and antibodies circulate in the blood that trap those microbes that tend 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.

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

Blood for analysis and other diagnostic methods

If intrauterine infection is suspected, a series of tests should be performed. In many ways, the type of study depends on the suspected pathogen. The following examinations are most often carried out:

• Blood test (ELISA study). Helps to 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 for the child. Analysis for TORCH infection in pregnant women
  • Bacteriological culture. For research, any material can be taken, depending on where the source of infection is supposed to be. Most often, a bacteriological examination is performed of the discharge from the genital tract (vagina and cervix), urine, the contents of the rectal mucosa, oral cavity, nose, and pharynx.
  • Detection of overt pathogens (eg, chlamydia, mycoplasma, etc.) or an excess of opportunistic pathogens (causing active infection only when present in high numbers) by more than 104 times is an indication for active treatment.
  • PCR. Helps to detect a pathogen even if its quantity is measured in units. For research, any biological fluid can be taken, as well as for bacteriological culture.

  Additionally, ultrasound is performed to confirm the presence of infection. It can reveal indirect signs of involvement of the placenta and the child in the process (for example, edema of the "children's place", thickening of the walls, impaired blood flow, fetal growth retardation, malformations, etc.), as well as evaluate the effectiveness of treatment and exclude other diseases.

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

  Treatment of intrauterine infection

  Treatment of intrauterine infections depends on their type, gestational age, as well as the condition of the mother and fetus. The following groups of drugs are used:

  • Antibiotics. They are prescribed if a bacterial infection, STIs are suspected (for example, found in the genital tract of chlamydia, ureaplasma, mycoplasma, in crops - a high amount of Escherichia coli, streptococcus, etc.). The choice of drug is determined by the sensitivity of microbes to it, which is indicated during sowing.
  • In some cases, broad-spectrum antibiotics may be prescribed. Also, the treatment takes into account the duration of pregnancy and potential risks for mother and baby.
  • Antivirals. They are used for the presumably viral nature of the infection (herpetic, CMV and others). The list of drugs allowed during pregnancy is small: Acyclovir, drugs based on interferons.
  • Immunotherapy. They are 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 gestation is as follows:

  • Planning pregnancy and maintaining all chronic diseases in the compensation stage. An examination for sexually transmitted infections is necessary, if necessary, treatment based on the results of the tests.
  • It is necessary to try to remove contacts during pregnancy with sick people, to avoid crowded places, especially children.
  • Examination for TORCH-complex in the absence of immunity, drawing up separate recommendations. For example, if a girl has never had rubella, you should be vaccinated against this infection and protect yourself from infection during pregnancy. In the absence of antibodies to toxoplasmosis, it is recommended to refuse to introduce new pets, cats, as they are carriers of pathogens.

  Intrauterine infections are dangerous conditions primarily for the child. They can lead to malformations of the fetus, disruption of the normal development of the baby, and even to his death or premature birth. It is important to timely identify any active inflammatory processes in the body of a woman and conduct appropriate treatment.

Good afternoon! Using my resource, I want to congratulate and support my good friend Yulechka, who became a mother yesterday. Unfortunately, the newborn baby was diagnosed with an infectious disease and the girls will not leave the hospital for a long time. To keep my finger on the pulse of events, I made an analysis of the main childhood diseases that can be encountered immediately after childbirth. The main problem of newborns is diseases. Both the mother and the medical staff should help the baby adapt in the first days of life. However, it is not uncommon for a child to become infected in the maternity hospital with infections that occur due to illness or underexamination of the mother, lack of sterility and improper behavior of doctors during childbirth.

Therefore, it is so important that from the first minutes of life the baby gets first colostrum, and then breast milk. Both products, as you know, contain a lot of substances useful for the child's immunity that can protect the baby from infection in the maternity hospital.

There are also intrauterine and congenital infections. Intrauterine arise from violations of the interaction between the fetus and the placenta, and congenital - rubella, hepatitis, AIDS and herpes.

Because of these viruses in the fetus, most diseases occur. In particular, due to herpes, a cytomegalovirus infection appears. That is why it is so important to take tests (including additional ones) for these diseases in early pregnancy.

Danger in the first days of life

Neonatal infections can be early or late. Early diseases include those that appear in a child in the first 72 hours of life. Late ones occur in a baby after 72 hours (or more) during a stay in the hospital. Children born prematurely are especially at risk of infection.

Prematurity infections include:

• pneumonia;
• meningitis;
• bacteremia;
• urinary infection.

On the one hand, these diseases still occur quite rarely, and on the other hand, they are very difficult and with complications, which in some cases leads to death. usually resolves with strong antibiotics and is an unavoidable option. Refusal of treatment with strong drugs will only aggravate the situation.

Diseases of the late period occur due to fungi and microorganisms. In the first place are staphylococcal infections and intestinal infections, that is, in fact, diseases of dirty hands. The symptoms of these infections are about the same: children sleep poorly, eat, and are generally quite lethargic.

Antibiotics are used for treatment, and as preventive measures - careful hygiene, when communicating with the baby - hand sanitizer.

What else should moms worry about?

Not so terrible, but still unpleasant, are newborn jaundice and umbilical infection. Yellow skin in a baby indicates a high level of bilirubin in the blood. This is a natural manifestation, especially in premature babies, but here it is very important to track the increase in this pigment in the analyzes, since the consequences are very serious - from cerebral palsy to mental retardation.

The main solution to the problem is to place the child under the so-called blue lamp, the light of which destroys the bilirubin pigments.

Until now, I was only aware of physiological jaundice, however, it turned out that there is also breast milk jaundice, pathological jaundice and hemolytic disease. And if the pigmentary reaction to breast milk is almost natural and can be corrected (and with the preservation of breastfeeding), then pathological variants require serious intervention due to their strong influence on the nervous system and brain of the child.

Among children's problems, infection of the baby's navel is also noted - these are various types of suppuration that occur due to non-observance of sterility during and after childbirth, often accompanied by staphylococcus aureus.

The newborn may develop suppuration, swelling, or ulcers at the site of the umbilical wound. Only doctors should treat such problems, since self-medication can lead to a severe deterioration in the child's condition.

If your baby has such problems, it is necessary to agree to hospitalization, because strong remedies, in particular, for immunotherapy, may be needed to get rid of the infection.

The post today turned out to be completely joyless, but I hope it will make expectant mothers think about prevention, getting rid of bad habits, timely treatment and constant during pregnancy. After all, the same cytomegalovirus infection can be detected in the early stages, and by finding out when it arose, help yourself and your unborn child.

Dear readers! I wish you, your friends and loved ones to avoid all the troubles that I wrote about. Let the kids come into this world healthy and full of strength! I send rays of good to everyone, I hope for a repost.