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Cytomegalovirus infection during pregnancy: treatment and consequences. Prevention of the virus for pregnant women. What to do if cytomegalovirus is detected during pregnancy: tips and reviews

Cytomegalovirus infection during pregnancy: treatment and consequences. Prevention of the virus for pregnant women. What to do if cytomegalovirus is detected during pregnancy: tips and reviews

02.08.2019

Many people know that CMV is not always a dangerous disease, but when cytomegalovirus is detected during pregnancy, panic sets in. All because Cytomegalovirus infection under certain circumstances can cause complications for the fetus, and subsequently for the child. Below we will look at what these circumstances are and what a woman needs to do during pregnancy in order to maximally protect the unborn baby from cytomegalovirus infection.

The vast majority of people do not have the necessary information about the actual presence of infectious cytomegalovirus in their body. This herpetic virus does not openly reveal itself, like other infections. Literally all the somatic signs of the disease are clearly felt by people with a deficiency of immunity - the special defense of the human body.

The maximum likelihood that children actually inherit CMV usually occurs when the mother is infected with cytomegalovirus during pregnancy. If antibodies to infection are present in the blood of a pregnant woman, the disease does not pose a significant danger to the unborn child.

But pregnant women are still at risk. Cytomegalovirus during pregnancy can indicate a serious danger in certain cases. To prevent the disease, it is necessary to know the routes of transmission of the herpes virus. Let's look at several causes of infection that pregnant women are often susceptible to:

Path of sexual transmission- This is the main way of infectious infection of adults. The virus enters the human body both through traditional sexual contact without protection, and through other sexual contacts, including anal or oral sex. Therefore, during pregnancy, you should ask your partner to check themselves for the presence of cytomegalovirus in their blood in order to avoid primary infection, if the pregnant woman has not yet had it.
Weakened immunity, which occurs due to frequent stressful situations, poor nutrition, or due to frequent colds which a woman is often exposed to during pregnancy.
Close contact with an infected person– when kissing through the mucous membranes of the lips and oral cavity. At the same time, during pregnancy it is also recommended to make sure that the partner is not infected with cytomegalovirus or does not have a relapse of the disease.
Household - with the general use of household items (cutlery, bed linen, towels, etc.).
Blood transfusion- this is an extremely rare, but quite real phenomenon, which means getting an infection through donated blood or through an organ transplant from a virus carrier.
Airborne– is transmitted through close contact with an infected person during sneezing or coughing, where during conversation the virus enters the body of a healthy person.

During pregnancy, CMV can easily end up in the child’s body both during the period of being in the mother’s womb, and during childbirth, or during feeding with mother’s breast milk.

The great diversity of CMV transmission lines is due to the fact that the infection can simultaneously be present in many areas of the body: in mother’s milk or blood, saliva and urine, as well as in tears and secretions found in the vagina.

Symptoms of cytomegalovirus infection during pregnancy

If a woman has during pregnancy the immune system works well, then CMV usually does not reveal itself by any external manifestation.

The virus is always dormant and waits for the immune system to lower its defenses. Having waited for this, the infection quickly makes itself known.

Let's look at some of the symptoms of cytomegalovirus that may appear during pregnancy: A rather rare main manifestation of the activity of cytomegalovirus infection, even during pregnancy, in people with absolutely normal immunity appears to be mononucleosis-like syndrome. He actively expresses himself elevated temperature
body, general malaise, immense headache. The syndrome manifests itself from approximately twenty days to two months from the moment of infectious infection. The average duration of mononucleosis-like syndrome can be from two to six weeks.
If there is a deficiency of immunity, cytomegalovirus during pregnancy can cause severe complications. Usually the consequences occur with the occurrence of pneumonia or encephalitis, myocardium, pleurisy, and arthritis. In addition, vegetative-vascular affective disorders and even multiple lesions of different organs of the human internal systems are likely.

Very rarely there are generalized forms in which the infection actively spreads to the entire body of a pregnant woman:

inflammation of the brain (most often leading to death);
inflammation of internal organs (kidneys, adrenal glands, liver, spleen, and pancreas);
paralysis (in very rare severe cases);
lung damage digestive system, as well as the eyes.

So, it is worth emphasizing that this infection is detected in the form of symptoms very similar to the symptoms of colds. All other listed symptoms appear very rarely, only when the immune system is in a very weakened state.

Diagnosis of CMV infection and pregnancy

It is almost impossible to independently determine the possible presence of cytomegalovirus when planning pregnancy. Of course, the virus, being in sleep mode, does not actively express itself in any way. Given the activity characteristic of the virus, the infection can be easily confused with other diseases with similar somatic symptoms.

To confirm the presence of the virus in the blood, you need to go to the clinic and conduct a differential diagnosis with specialists.

After a visual examination of the patient by the attending physician, certain examinations are prescribed. The following comprehensive special methods for diagnosing cytomegalovirus are planned: Cytological medical examination of urine and saliva.
Biomaterial (saliva and urine) is examined under a microscope. During pregnancy, cytomegalovirus infection is diagnosed by the actual presence of giant cells in the smear. Polymerase chain reaction (PCR).
It is based on the precise determination of CMV DNA, which is the active carrier of the hereditary notification of the virus and is necessarily contained within it. To conduct a medical examination, scrapings and blood are used, as well as saliva, sputum and urine. Serological studies of blood serum. The purpose of these studies is to identify antibodies. Maximum correct method

Immunoglobulin M (IgM) is usually formed 28 to 49 days after infection. Their high degree decreases with the further formation of the immune response, while the number of immunoglobulins G (IgG) increases.

Immunoglobulins are proteins that are produced by blood cells. They closely combine with pathogens, which, in turn, actively penetrate the human body and easily form a complex.

The persistent presence of IgG immunoglobulins indicates that the infection occurred earlier and antibodies have already been developed. Timely detection of IgM immunoglobulins clearly confirms the primary introduction of the virus into the human body.

If there are no IgG and IgM immunoglobulins, then future mom automatically included in the risk group for primary infection due to the lack of antibodies in the body. In turn, this is fraught possible consequences for the physical health of the fetus.

In children born from an infected mother in the first month and a half from the onset of birth, blood tests are examined for the possible presence of antibodies to IgG and IgM. If IgG immunoglobulin is detected in the child’s blood, this is not a characteristic symptom of congenital cytomegaly. The presence of IgM immunoglobulin confirms the acute stage of the infectious disease.

Treatment methods for cytomegalovirus in pregnant women

Cytomegalovirus during pregnancy is an almost incomparable concept, especially during the first infectious infection. In some cases, there is a fairly high risk of the possible manifestation of various somatic abnormalities in the development of the fetus. The risk of undesirable consequences for the fetus is much reduced if the expectant mother promptly contacts the clinic for consultation and examination by specialists.

Treatment of cytomegalovirus infection in pregnant women, detected through laboratory tests, is mandatory if reactivation of a latent viral disease occurs. And also during primary infectious infection in acute form.

Unfortunately, modern medical science has not yet developed drugs that can destroy cytomegalovirus in the human body forever. Therefore, the goal of treatment is to eliminate somatic symptoms and fix the virus in a passive (inactive) state.

Medications

For cytomegalovirus during pregnancy, it is advisable to use antiviral drugs and immunotherapy. In the first, second and third trimester, 3 courses of treatment with immunoglobulin (a special cell found in human blood that supports his immunity) are carried out.

Immunoglobulin Neocytotect - solution. Immunological drug. For the prevention of CMV infection in patients with a drug-suppressed immune system. Therapy for CMV infection in patients with a weakened immune system, in particular premature infants or newborns. Prevention of disease manifestation after CMV infection.
Immunomodulators. Viferon - suppositories, ointment or gel - from the group of interferons (a drug with antiviral effects). Kipferon, suppositories - a combination of immunoglobulin and interferon (used in the treatment of viral etiology and acute viral causes of the disease). Wobenzym, tablets – a combined enzyme (antimicrobial, anti-inflammatory, antiviral, immunomodulatory, analgesic with decongestant properties).
Antiviral. Valacyclovir - tablets (prevention and treatment of CMV, analogues - Valcicon, Valvir, Valtrex, Valciclovir Canon).

Vitamins

Currently, it is not always possible for pregnant women to eat properly and regularly. Comprehensive support for the body with vitamins will come in handy. They compensate for the lack of certain micro and macroelements in the mother’s body, from which the fetus takes resources for healthy development.

Let's look at some of the best vitamins for pregnant women:

During the first trimester. Vitamin A - prevention of nervous system disorders; vitamin C - enhances the immune system, the body's fight against viruses and infections; iodine - for the proper creation of the fetal nervous system; vitamin E - for the proper creation of the placenta.
During the second trimester. Iron - to reduce the risk of anemia; iodine - during the creation of the fetal skeleton and formation mental abilities; calcium - takes part in the creation endocrine system and kidneys.
During the third trimester. Vitamin C - improves immune function; magnesium - for prevention premature birth; vitamin D - for the prevention of rickets, for the proper formation of the skeleton.

So, to summarize, it is worth noting that cytomegalovirus is not always dangerous even during pregnancy. But you should do everything to protect yourself from the possible manifestation of cytomegalovirus infection. And if a pregnant woman has not yet encountered the virus, then it is necessary to protect herself from all potential carriers until the child is born. And also if you have already passed the tests and want to decipher them, we advise you to read the article -

Should we sound the alarm if antibodies to cytomegalovirus are detected in the expectant mother’s blood? After reading the article, you can learn about the characteristics of the infection and possible risks for the expectant mother and child.

All infections caused by viruses from the HERPESVIRIDAE family (herpesviruses) have a similar pathogenesis: the disease persists, occurs in a latent or chronic form. So is cytomegalovirus: it can “sleep” in the body long years, without making itself felt at all or waking up (reactivating) from time to time.

Causes and symptoms of cytomegalovirus

Cytomegalovirus hominis (Human Cytomegalovirus) is a DNA-containing pathogenic microorganism that belongs to the family HERPESVIRIDAE (Herpesviruses). The name of the virus, “giant cell,” comes from the fact that the cells it affects can be multinucleated and enormous in size.

Cytomegalovirus is also different in that it can long time persist in the environment. This partly explains its high infectiousness.

IMPORTANT: According to WHO (World Health Organization), 2 out of 10 adolescents and 4 out of 10 adults are carriers of one or another strain of Cytomegalovirus hominis.

The source of CMV infection is an infected person. Cytomegalovirus hominis is found in his saliva, tears, nasopharyngeal secretions, semen, female genital secretions, urine and feces.

Routes of transmission of CMV and forms of CMV infection.

Cytomegalovirus hominis is transmitted, regardless of the strain:

contact (including through objects)
airborne
through the placenta from mother to child
for organ transplants or blood transfusions

Infection with cytomegalovirus infection occurs very often, its gateway is the mucous membrane lining the genitals, upper respiratory tract and gastrointestinal tract. However, the body of a healthy person can cope with it, so the disease in the vast majority of people occurs in a latent form.

IMPORTANT: The incubation period of CMV infection is 30-60 days. If a person’s immunity is strong, it suppresses the disease in 1-2 months. Suppresses, but does not cure: not active form Cytomegalovirus hominis can live in the host’s body for years and be reactivated under favorable circumstances, that is, in the event of a decrease in immunity. It is difficult and not always possible to distinguish primary infection from reactivation of the virus.

Symptoms of infection appear in those who are in a state of immunodeficiency. Acquired cytomegalovirus disease is often called mononucleosis-like syndrome and manifests itself as follows:

weakness
low-grade fever or fever
myalgia (muscle pain)
swollen lymph nodes

Since Cytomegalovirus hominis can infect the respiratory system and liver, in some patients acute CMV infection can manifest itself as influenza or viral hepatitis.

If a person’s immune system is strong, after 30-60 days anti-CMV immunoglobulin is produced, and the symptoms of the disease subside.

IMPORTANT: A carrier of Cytomegalovirus hominis remains infectious for weeks and months after symptoms of CMV infection disappear.

In people with weak immune systems, as well as in pregnant women and young children, cytomegalovirus can cause:

retinitis (inflammation of the retina of the eyes)
pneumonia
hepatitis
enterocolitis
ulcers of the esophagus, stomach, intestines
inflammation of the genital organs
encephalitis

Symptoms of cytomegalovirus during pregnancy. What is cytomegalovirus reactivation during pregnancy?

The development of CMV in pregnant women is possible in two cases:

during primary infection (the risk of transplacental infection is higher)
in case of reactivation of a virus dormant in the body (the risk of transplacental infection is lower)

If the expectant mother is a carrier of the virus, but does not have symptoms of the disease, infection of the child through the placenta may not occur.

Weakness, fever and enlarged lymph nodes are signs of CMV - an acute infection.

The clinical forms of infection caused by Cytomegalovirus hominis in expectant mothers are also different.

If the disease is acute, the lungs, liver, eyes, genitals, and brain may be affected. A pregnant woman may have complaints about:

weakness and fatigue
specific discharge from the nose or genital tract
enlarged and painful lymph nodes

CMV infection affects the normal course of pregnancy. If the disease is acute, the expectant mother is often diagnosed with:

vaginitis
colpitis
hypertonicity of the uterus
premature aging of the placenta
oligohydramnios

CMV infection can also come back to haunt a pregnant woman:

premature placental abruption
weakening labor activity
blood loss during childbirth
postpartum endometritis

VIDEO: Cytomegalovirus infection and pregnancy

Cytomegalovirus during pregnancy: consequences for the fetus

Cytomegalovirus hominis can also affect a baby in the womb.

If intrauterine infection with CMV infection occurs in the early stages, pregnancy may fail.

IMPORTANT: Doctors consider the most dangerous situation to be when intrapartum infection of a child with cytomegalovirus occurs in the first trimester of pregnancy. There is a risk of fetal death or the occurrence of various serious developmental defects.

Perinatal pathologies caused by CMV infection are:

Regardless of the stage of pregnancy at which the infection occurred: stillbirth, prematurity, fetal malnutrition
Infection occurred in the early stages: malformations of the nervous system (microcephaly, hydrocephalus), respiratory organs (pulmonary hypoplasia), digestive organs, urination, heart defects
The infection occurred on later: birth of a child with pneumonia, jaundice of various origins, hemolytic anemia, nephritis, meningoecephalitis, etc.

Unfortunately, congenital CMV infection can result in developmental defects and health problems for the child in the future.

A child with congenital CMV infection may look absolutely healthy at first. But over time, the following may appear:

hearing impairment up to deafness
visual impairment up to blindness
decreased intelligence
speech problems

Cytomegalovirus during pregnancy planning. Analysis for cytomegalovirus during pregnancy

A woman who is serious about planning a pregnancy consults with a gynecologist, and already at this stage undergoes a test for TORCH infections, which allows her to identify a number of serious diseases that can disrupt the course of pregnancy and affect the health of the child, or antibodies to them .

IMPORTANT: The “C” in the abbreviation TORCH stands for Cytomegalovirus hominis.

The cytomegalovirus test is part of the TORCH complex.

A serological blood test allows a woman to detect the presence of anti-CMV immunoglobulins class M and G and its titer.

Antibodies to cytomegalovirus - what does it mean? Deciphering the analysis for cytomegalovirus in pregnant women

The results of an analysis for Cytomegalovirus hominis in a pregnant woman will allow the doctor to get answers to three important questions:

Is the expectant mother infected with cytomegalovirus?
if yes, when did the infection occur?
if yes, is the virus active?

Analysis transcript

Indicators of cytomegalovirus during pregnancy, normal. What do cytomegalovirus titers mean during pregnancy?

A test that does not reveal IgM and IgG antibodies to Cytomegalovirus hominis is considered normal. This means that the woman is not infected. But there is absolutely no guarantee that infection will not occur in the period of time preceding childbirth.

A high titer of IgM in the absence of IgG indicates an acute period of CMV infection and, accordingly, a high risk of infection of the fetus
A high IgG titer in the absence of IgM indicates virus carriage and the possibility of reactivation
Low titer of IgM and IgG – infection at the attenuation stage
High titer of IgM and IgG – reactivation of Cytomegalovirus hominis

Changes in the titer of antibodies to CMV.

Treatment of cytomegalovirus. How to treat cytomegalovirus during pregnancy?

Unfortunately, it is impossible to completely eliminate Cytomegalovirus hominis once it has entered the body. But medicine knows ways to mobilize a person’s own immunity to fight it.
Pregnant women are usually prescribed antiviral and restorative medications. These are drugs based on interferon or herbal preparations. For example, the drug Proteflazid is considered effective.

CMV cannot be cured, but it can be controlled.

If there are no antibodies to cytomegalovirus in the blood of the expectant mother, she should take preventive measures:

do not change sexual partner
use condoms
observe personal hygiene rules
do not eat from someone else's dishes
clean the apartment regularly
pay due attention to your own health

What to do if cytomegalovirus is detected during pregnancy: tips and reviews

If a pregnant woman is diagnosed with Cytomegalovirus hominis, she should not consider it the end of the world. The key to a normal pregnancy is constant interaction with your doctor and strict adherence to his instructions.
In the case of an acute form of infection, the expectant mother should be tested to monitor the antibody titer every two weeks, and also be regularly examined to monitor the development of the fetus.

VIDEO: Cytomegalovirus during pregnancy

From the article you will learn what cytomegalovirus is and under what circumstances it becomes dangerous during pregnancy.

We will also tell you what signs you can use to suspect cytomegaly disease and how to deal with it.

What is cytomegalovirus

Experts refer to cytomegaloviruses (or abbreviated as CMV) as pathogens of a viral nature (herpesvirus family). Its prevalence on Earth is very wide.

More than 40% of the population aged 35 years have been in contact with this infectious agent. In the group of older people this figure is even higher. Dr. Komarovsky believes that every adult has encountered cytomegalovirus.

CMV is capable of remaining for a long time in human body without showing itself in any way. It is most often found in the salivary glands in people who feel well. Once it has penetrated the human body, it remains there for many years, occasionally appearing with a cold or not revealing itself at all.

A dormant virus does not cause any concern. But with increased stress (stress, hypothermia, changes in routine, time zone changes, etc.), the activity of the immune system decreases. Against this background, reactivation occurs - the cytomegalovirus turns from a harmless neighbor into an aggressor.

During pregnancy, the body's defenses are reduced. If the “dormant” virus ceases to receive the necessary resistance from the immune system, a disease occurs. This is why cytomegalovirus manifests itself so often during pregnancy.

How does a pathogen enter the body?

No infection occurs from animals (cats, dogs, etc.). The source becomes a person (who has recovered or is a carrier). It is quite difficult to become infected with cytomegalovirus infection. Even repeated close contact with the pathogen does not always lead to illness.

Scientists have been actively arguing about the ways in which a pathogenic agent enters the human body for more than 60 years (since the discovery of the herpes virus).

Most of them identify the following channels for CMV penetration into the human body:

Contact and household(when transferring saliva during kissing, using general hygiene products, contact lenses, utensils, etc.). The virus with this method of infection is in an active form and in large quantities secreted into saliva, tear fluid, etc.
Sexual(the most common route of transmission of herpes). In this case, cytomegalovirus is transferred from partner to partner with biological fluids (sperm, vaginal secretions). Without the use of barrier contraception (condoms), this route of transmission is typical for any type of sexual contact. Anal and oral sex are no exception.
Blood transfusion(during blood transfusion). In this case, the pathogen directly enters from one bloodstream to another. A number of authors include the transplantation route (transmission of cytomegalovirus along with organs during transplantation) into this group.
From mother to child. Such CMV infection occurs transplacentally (through the placenta) during intrauterine development. The pathogen passes from the woman to the child during labor, when the contact between the two organisms becomes most intense. Breast milk at natural feeding also contains cytomegalovirus.
Airborne or aerosol. This mechanism of CMV migration is considered extremely rare. The release of the pathogen along with fluid during breathing and coughing does not raise any doubt. But many experts reject the possibility of becoming infected in this way.

Types of cytomegalovirus infection

No matter how long the period of latent manifestations continues, after the activation of the pathological agent in the human body, the pathological process begins. Cytomegalovirus infection (CMVI), or cytomegaly (the so-called disease caused by CMV), is divided into several groups for ease of understanding.

The simplest way to classify this is by the organs affected by the disease: damage to the lungs (pneumonia), liver (hepatitis), stomach (gastritis), etc. This is not very convenient.

Firstly, if several organs are affected at once, it is difficult to compose, and also understand, the name of the disease. And secondly, this does not reflect the full severity of the pathology. After all, when the lungs are damaged, not only they suffer: the temperature rises, appetite decreases, etc.

Therefore, we will divide cytomegalovirus infection by timing of infection and course:

acquired— this group includes latent, acute mononucleosis and generalized (widespread) cytomegalovirus infection;
congenital— penetration of the virus occurs during pregnancy. Intrauterine infection of the fetus can lead to the development of acute or chronic forms of pathology;
infection in immunocompromised patients— this group includes patients suffering from AIDS and patients with organ transplants. In the first case, a significant decrease in the body's defenses is caused by HIV. In the second case, suppression of the immune system is caused by drugs. They help the transplanted organ take root in another body. If treatment is canceled, the transplant may end in disaster. The immune system does not resist at all and the virus penetrates all organs without obstacles. Whatever the cause of immunodeficiency, the most severe forms of cytomegalovirus infection develop against it. They are called generalized. In this case, the disease affects the entire body.

Signs of cytomegalovirus infection

It is difficult to suspect CMV infection on your own.

It has a varied course and often resembles other diseases (ARVI, gastritis, etc.).

Laboratory signs of cytomegalovirus infection

To detect cytomegalovirus and make the correct diagnosis, laboratory diagnostics are used:

Virus DNA found using PCR. This is a way to detect even a tiny fragment of a pathogen. The result of the polymerase chain reaction will be positive if there is a live cytomegalovirus or fragments of its DNA (genetic material) in the blood, smear, or other biological fluid. This method is widely used to diagnose the disease. It is highly accurate. But if its results are positive (indicating the presence of a living or killed microorganism), it is impossible to say exactly when the penetration into the human body occurred and at what stage of activity the pathological process is.
Antibodies determined using a serological method. In this study, what is detected in the blood serum (and only in it) is not the virus itself, but how the immune system responded to its introduction. After penetration of the pathogen, blood cells “recognize” it and produce special proteins - immunoglobulins (Ig). They are the ones who rush to fight uninvited guests. IN different periods disease, several classes of immunoglobulins (M, G) are produced in the blood. Based on the ratio of their quantities (titles), the time of the start of the meeting with the pathogen is judged.
Avidity. To stop viral activity, immunoglobulins combine with it, forming a complex. How stronger connection pathogen lg, the higher the avidity. High-avidity antibodies are those immunoglobulins that reliably attach to the virus and do not allow it to live freely.

Clinical signs of cytomegalovirus infection

The form of the disease depends on the time of its onset, the state of health, and problems with other organs. Let's figure out what CMV infection is.

Types of manifestations of acquired cytomegaly:

latent;
mononucleosis-like;
generalized.

Latent form

This is the same condition in which the virus is present in the body, the immune system fights it, but there are no complaints. The temperature is normal, there is no pain or cough, and the person feels absolutely healthy.

However, in the blood we can see signs of an immune response provoked by the pathogen. They will be antibodies (proteins) that the body produces in response to the introduction of a pathological agent.

Acute mononucleosis-like form

It got its name because its manifestations are similar to those of mononucleosis (and in most cases, ordinary ARVI). In this case, the temperature rises to 37.0-37.5, headaches and runny nose appear.

Symptoms of general malaise (fatigue, weakness) are complemented by pain or discomfort in the area of the salivary glands. The most common area of concern is the submandibular area. It swells and hurts, especially when pressed. If the parotid salivary glands become inflamed, then discomfort misleadingly indicate otitis media (ear inflammation).

Symptoms do not improve and continue for 2 or more (up to 6) weeks. Cytomegalovirus infection of this type appears later than 3 weeks from the moment of infection of the pathogen. It is often mistaken for a common cold.

The only thing that is alarming is the involvement of the salivary glands in the inflammatory process (not necessarily). When carrying out laboratory diagnostics, both the pathogen itself and antibodies to it are detected.

The consequences of the disease are manifested by general weakness, increased or decreased blood pressure, and fatigue. In rare cases, the disease is complicated by pneumonia (inflammation of the lungs), arthritis (of the joints), and myocarditis (damage to the heart muscle).

Generalized form

This is an extremely severe variant of the disease with an unfavorable prognosis. It occurs with significantly reduced immunity.

In this case, they are affected internal organs:

Kidneys. At the same time, in addition to a deterioration in the general condition and an increase in temperature, signs of damage to the genitourinary system are observed. Pain or heaviness in the lumbar region, increased urination, change in the amount and color of urine.
Gastrointestinal tract. Signs of a digestive system infection occur in various combinations: nausea, vomiting, diarrhea, heartburn, abdominal pain and bloating, belching, sweet or bitter taste in the mouth.
Respiratory system. If the inflammation has affected the bronchopulmonary structures, then characteristic features There will be cough, shortness of breath, chest pain.
Heart. Myocardial damage is manifested by interruptions in heart function, pain, instability of blood pressure, and weakness. It is difficult to identify such signs on an ECG, but in laboratory research the presence of a virus is detected.
Nervous system. Damage to the membranes and structures of the brain is an extremely serious pathology. Sensory disturbances and paralysis are characteristic of the terminal stage of inflammation.
Circulatory system. Cytomegalovirus enters the blood, which carries it to every organ. Inflammation develops everywhere. Most often, such inflammation leads to the death of the patient.

Cytomegalovirus during pregnancy - how serious is it?

Pregnancy is not only a happy time waiting for the birth of a child, but also intense work of the whole body. The load on the immune system increases during this period, and it copes worse with infectious agents. The cells of the growing fetus are different from the mother's body, so for successful gestation the immune response is further reduced naturally.

When the body's defenses are weakened, CMV is activated, so pregnant women are at risk for developing the disease. If a woman is infected or the cytomegalovirus “dormant” in her body is launched during pregnancy, a congenital cytomegalovirus infection develops, the signs of which we have already mentioned.

According to statistics, about 5% of pregnant women suffer from CMV infection, while less than 1% of newborns become ill. The rest of the babies are reliably protected by the mother's antibodies.

In utero, fetal pathology occurs in different ways. The variety of manifestations of the disease includes the full spectrum - from asymptomatic carriage to intrauterine death.

Consequences for mother and baby

A pregnant woman experiences CMV infection in the same way as other adults. We have already discussed the variants of the course of the disease above.

The effect of infection on a child directly depends on the time of its occurrence. The shorter the pregnancy, the more severe the disorders.

Most frequent consequences We will consider the influence of the herpes virus on the fetus in the table:

Term of intrauterine development	Possible variants of pathological changes
0-14 days	Intrauterine fetal death, miscarriage or multiple organ damage, malformations resembling genetic diseases, frozen pregnancy.
15-75 days	Violations of the structure of cells and organs, miscarriages.
76-180 days	A common inflammatory process that ends with the replacement of normal cells in the internal organs with connective tissue (harder). Abortion.
From 181 days until the moment of birth	Widespread inflammation with the greatest damage to one or more organs (liver, meninges, circulatory system, lungs, etc.).

In the early stages, the likelihood of losing a baby is higher, since cytomegaly leads to significant damage to the structures of the fetus. The longer the pregnancy, the higher the chance that the child will live.

Treatment methods

Alas, science has not yet invented a means to 100% eliminate cytomegalovirus. But there are drugs that inhibit the spread of the disease and improve its course. Their choice depends on the stage of the disease.

Cytomegaly is treated with two types of medications:

Antiviral drugs(groprinosin, viferon). They do not destroy the pathogen, but reduce its activity. In this case, the risk of complications (for both mother and child) is significantly reduced. The doctor will prescribe a drug that is approved for the required gestation period.
By symptomatic means. They fight individual manifestations of the disease. For rhinitis (runny nose), rinses and drops are prescribed that disinfect the nasal cavity and prevent the development of tracheitis, pneumonia and other complications.

As a rule, cytomegalovirus infection occurs against the background of exacerbation chronic diseases. The lack of necessary treatment for “common” diseases not associated with CMV threatens to result in the generalization of the process. Therefore, at the first symptoms of chronic pathology, they begin to treat it, without waiting for complications.

Pregnancy is a responsible event and you need to take it seriously - do not forget to examine your body and do the necessary tests. What does it mean if it turns out that cytomegalovirus IgG is positive during pregnancy, will this affect its course and the development of the fetus? This infection belongs to the herpetic group, therefore, like all diseases of this group, it is often asymptomatic or the symptoms are not pronounced.

But it is very important to establish, if the test is positive, whether there are antibodies to cytomegalovirus in the blood.

After all, any pathological process during pregnancy can lead to negative influence on the child's body. The main thing in treatment is to remember that you need to consult a doctor in everything, do not self-medicate!

In this article you will learn:

Positive IgG

If the result for cytomegalovirus IgG is positive, this does not mean that the patient’s health is threatened or that a pathological process is actively occurring in the body. In most cases, this means that a person has immunity to this infection, but he is a carrier of it. Once infected with cytomegalovirus, it remains in the body for life, even after treatment.

In the manifestation of this virus, the state of the immune system and the body’s resistance to diseases are of great importance. If the level of health and immunity remains at high level, then the virus may not manifest itself throughout life. It is necessary to test for antibodies to CMV in a pregnant woman, since the child’s body is not yet capable of producing them against infections.

Primary infection

During pregnancy, cytomegalovirus can manifest itself both in the form of a primary infection and in case of relapse; this is primarily due to a decrease in the woman’s immunity, an increased load on her body and a decrease in resistance to antigens.

If the tests turn out to be positive IgM, this means that a primary cytomegalovirus infection has occurred. After all, this type of immunoglobulin is produced by the body a short time after infection in order to be the first to fight the infection. It is believed that primary infection is more dangerous because the body has not yet developed antibodies to the virus that can fight the infection and for this it needs a lot of energy and high immunity.

The infection is transmitted by airborne droplets, contact, sexual and intrauterine routes, that is, it is possible to infect a child even before his birth. Unfortunately, this can affect the development of the fetus. Therefore, if antibodies are detected in the first 12 weeks of pregnancy, it is necessary for the doctor to urgently prescribe treatment.

Relapse of the disease

The situation when the mother had CMV before pregnancy is most often more favorable. This is due to the fact that the resistance of immunity to a specific type of pathogen is high; antibodies are already circulating in the blood, which are ready to fight and protect the body of the mother and fetus.

The presence of a relapse is indicated by the appearance of IgG in the blood, which exists throughout life and is often produced after the infection has been cured.

Interpretation of a blood test for TORCH infection

TORCH infections are a group of toxoplasmosis (T), rubella (R), cytomegalovirus infection (C) and herpes (H), the letter “O” denoting other infections that may affect the child. These diseases are combined because of their danger to the fetus during pregnancy. The purpose of them is to calculate the presence of IgG in a woman. In their absence, the expectant mother must take precautions and be observed by a doctor throughout her pregnancy.

The result of the analysis for cytomegalovirus is obtained after an enzyme-linked immunosorbent assay (ELISA), which detects early (M) and late (G) antibodies. Ideally, a woman should have these tests done before she plans to become pregnant.

IgG class

A positive result for produced IgG to cytomegalovirus indicates the presence of immunity to this disease. This best option During pregnancy, the risk that the woman will get sick is small and the threats to the child are minimal.

They are synthesized by the body itself and protect the human body throughout life. They are produced later, after the acute process has occurred and even after treatment.

IgM class

Depending on whether there is any, the risk of fetal abnormalities is assessed. These immunoglobulins are quickly produced to fight infection. But they do not have memory and die after some time, thus not creating immune protection against the pathogen.

Avidity of immunomodulins

Avidity characterizes the strength of the connection between antigens and antibodies specific to them. The avidity of IgG increases over time, making it possible to estimate how long ago the infection with the pathogen occurred.

The results can be assessed as follows:

A negative test means no infection in the absence of IgG and IgM;
Less than 50% – infection occurred for the first time;
50-60% – you need to repeat the test after some time;
60% or more – there is immunity, the person is a carrier of the infection, or the process is chronic.

Congenital cytomegalovirus infection

This form of CMV occurs as a result of intrauterine infection of a child. In most cases, it does not manifest itself, and children remain carriers of the infection. In some children, symptoms appear in the first years, and even months, of life.

They may appear as:

Anemia;
Hepatosplenomegaly (enlarged spleen and liver);
Nervous system disorders;
Jaundice, that is, liver damage will indicate yellow baby's skin;
Appearances blue spots on the skin.

These characteristics may also indicate other diseases; for this reason, it is important to monitor the health of the newborn, examine and study the condition of its organs at some intervals. In addition, other damage to the body is possible, the development of developmental anomalies, heart defects, deafness, cerebral palsy or mental disorders.
The presence of cytomegalovirus infection in an infant is indicated by a fourfold increase in the IgG titer in tests done with an interval of one month. In infants, the presence of CMV can be seen with muscle weakness, if they suck milk poorly, have little weight, often experience vomiting, tremors, convulsions, decreased reflexes, and so on. In older children, at 2-5 years old, mental retardation and physical development, sensory systems and speech disorders.

How is CMV infection treated in children and adults?

A person who has had cytomegaly remains a carrier of its causative agent for the rest of his life, because even today medicine can only reduce the manifestation of symptoms.

Therapy is complex and depends on how affected the body is.

Vitamin, immunomodulating and antiviral drugs are prescribed. Only the attending physician determines which medicine is needed;
In some cases, they carry out symptomatic treatment, to improve the general condition of the patient;
It is important to eat rationally and lead a healthy lifestyle to strengthen the immune system;
The doctor should prescribe antiviral drugs only if the patient’s condition is serious;
Specific antimegalovirus immunoglobulin and interferon are prescribed;

It is important to establish the presence of the virus in the body in time in order to begin treatment as early as possible. By doing this, the patient will not only take care of her health, but will also protect her baby from future health problems and the development of organ defects.

Pregnancy is a serious test for the immune system of the expectant mother. It is during this period of time that a woman’s health is exposed to all sorts of dangers: infections and viruses never sleep! In addition, a mother’s illnesses can negatively affect the intrauterine development of her baby. The most serious threat to the fragile tandem of mother and child is cytomegalovirus (CMV). This infection underlies various fetal defects and can also cause its death even before birth.

The lips of each of us at least once in our lives have been “decorated” by herpes - a scattering of small itchy blisters filled with a clear liquid. By the way, lips are not the only place where such a “cold” can settle. The skin of the face and upper half of the body is at risk. Not only does the herpetic reaction negatively affect appearance, it also causes great discomfort in the form of pain and severe itching. Once it enters the body, the virus will never leave a person again, manifesting itself at moments of greatest weakening of the immune system. Cytomegalovirus, which all pregnant women should be wary of, belongs to the large family of herpes viruses.

General information about CMV and the route of infection with the virus

Scientists discovered and identified cytomegalovirus in 1956. Today, cytomegaly (CMV infection) is widespread: we can safely say that the majority of the inhabitants of our planet are carriers positive cytomegalovirus. The most interesting thing is that many of them don’t even know about it! Until a gap is formed in our immune system, the infection remains latent. This means that all the “delights” of herpes are experienced by people who already get sick often, since their health is very weak. It is no wonder that pregnant women are at greatest risk, because their immune system works double duty!

How does cytomegalovirus work in the body? After contact with this infection, healthy cells begin to rapidly increase in size (it is no coincidence that the concept of “cytomegaly” is translated as “giant cell”). Pathogens disrupt the integrity of the cellular structure, as a result of which the cell fills with fluid and becomes like an owl's eye.

You can “catch” CMV infection during pregnancy in several cases:

during sex. This is the most common method of infection when it comes to adults. To enter the body, cytomegalovirus uses any “loophole”: kissing, genital sex, oral sex or anal sex without using a condom;
at home. Infection through this route occurs infrequently, only when the virus is not “dormant” but is in active form. The infection may be waiting in the wings on the bristles of a toothbrush, the lint of a towel, or the surface of dishes;
by blood transfusion method. The risk of infection with cytomegalovirus remains during donor blood transfusion, during organ or tissue transplant surgery, and when using donor eggs and sperm.

The large number of ways of infection is due to the fact that the infection exists quite calmly in all liquid media of the body. Comfortable conditions for the life activity of the pathogen are blood, tears, breast milk, sperm, vaginal discharge, urine, saliva.

IN children's body The infection can invade while the baby is in the womb, during birth, or during breastfeeding.

Signs of CMV during pregnancy

It is unlikely that the virus will manifest itself in a completely healthy person. In his body, the infection can “dormant” for years, waiting the right moment. As soon as the immune defenses weaken, CMV will make itself felt.

It is extremely rare that symptoms of cytomegaly appear in a person with normal immunity in the form of mononucleosis-like syndrome. Then the patient experiences general malaise and headache, and develops a high fever. The disease develops 1.5 – 2 months after the virus has entered the body. A person may feel unwell for 2 to 6 weeks.

During pregnancy, cytomegalovirus most often “masks” itself as an acute respiratory viral infection (ARVI). It is this feature of CMV that misleads the expectant mother: she accepts dangerous infection for a common cold. Indeed, the symptoms of the virus can hardly be called specific - fever, general weakness, constant fatigue, rhinitis, headache, a severe inflammatory reaction involving the salivary glands and tonsils. The main distinguishing feature of cytomegaly from a cold is that all the symptoms of CMV persist for a long time and a person can be sick for 1 - 1.5 months.

If the immune system is very weakened, CMV infection during pregnancy can be accompanied by various complications such as pneumonia, pleurisy, encephalitis, myocarditis, and arthritis. In addition, some patients with exacerbation of CMV experience disorders of the autonomic-vascular system and inflammation of various internal organs.

Particularly severe cases, when the pathology takes on a generalized form and covers the entire body, are accompanied by the following complications:

a widespread inflammatory reaction that extends to the kidneys, pancreas, spleen, adrenal glands and liver tissue;
destructive processes affecting the gastrointestinal tract, lungs and eyes;
paralysis (isolated cases);
inflammation of the brain, which can be fatal for the patient.

The generalized form of CMV infection is quite rare.

Let us emphasize once again that in most cases, CMV infection during pregnancy manifests itself as a common cold. Complications occur when a person’s immunity is extremely weakened.

Danger of positive CMV during pregnancy

For an adult, cytomegalovirus does not pose a particular threat, which, unfortunately, cannot be said about a baby who grows under the mother’s heart. Infection can cause numerous abnormalities in the intrauterine development of the fetus.

In addition to cytomegalovirus, pregnant women are also at risk of other forms of herpes infection. Among them is the herpes simplex virus (HSV), which, according to severity and location, is divided into two types - first and second. The greatest danger to the fetus is the herpes simplex virus type 2. You can become infected with it “through the bed,” and as a result, itchy blisters appear on the mucous membrane of the pregnant woman’s genitals.

CMV and HSV during pregnancy have gained fame as the most severe infectious diseases after rubella - their consequences for the health of a tiny person are so serious. If the second type of herpes virus has settled in the expectant mother’s body, it can penetrate the structure of the amniotic fluid and thus enter the fetus’ body. However, medical practice shows that infection of a child occurs mainly through the placenta; there are also frequent cases when an embryo becomes infected with CMV through maternal blood.

Primary infection with HSV during pregnancy does not bode well: risk spontaneous miscarriage increases significantly. The infection develops mainly in the nervous tissue, and as a result, children are born with abnormalities in the nervous system (for example, sensorineural hearing loss). Sometimes the fetus becomes an accessible target for meningoencephalitis, which provokes the development of edema of the brain and delayed development in the child after birth.

Unfortunately, intrauterine infection of a baby most often occurs when his mother does not know that she is a carrier of a dangerous virus, that is, she does not have any alarming symptoms.

A woman becomes very vulnerable at the very beginning of pregnancy. If cytomegalovirus manages to penetrate the fetus through the placenta at this time, the child may die.

When infection occurs in later stages of pregnancy, the fetus does not die, but its internal organs can be severely damaged by the virus. Among developmental deviations there are also various deformities, birth defects heart, hepatitis, jaundice, inguinal hernia, microcephaly.

The picture of the consequences of CMV infection is so disappointing that it can plunge a pregnant woman into panic. However, everything is not as bad in reality as it seems: if the virus is detected in a timely manner, the condition of the expectant mother and fetus can be corrected with appropriate treatment, that is, terrible consequences can be avoided. In addition, it is very important to plan motherhood in advance, as well as donate blood to be screened for infections that represent potential threat for the intrauterine development of the child.

Analysis for CMV during pregnancy

It is not possible to verify the presence of cytomegalovirus in your body on your own. The latent form of the virus does not manifest itself in any way, but even if it acquires an active form, it can easily be confused with an elementary cold and not given high temperature and general weakness of special significance.

You can protect yourself and your baby by checking in due date an analysis that determines the presence of TORCH infections in the blood of a pregnant woman. Thanks to this examination, it is possible to promptly detect such dangerous diseases as toxoplasmosis, rubella and herpes simplex virus types 1 and 2.

To test for cytomegalovirus during pregnancy, use:

polymerase chain reaction;
microscopic examination of sediments of urine and saliva;
serological analysis of blood serum.

The principle of polymerase chain reaction is to search for deoxyribonucleic acid in a woman's body. This substance, which is located inside CMV, encodes the hereditary data of the virus. Scrapings, urine, sputum or saliva are suitable biological material for analysis.

The subjects of microscopic examination of the cytological method are the urine or saliva of a pregnant woman. The presence of cytomegalovirus confirms the presence of huge cells.

Examination of blood serum during a serological test helps to find antibodies specific for CMV infection. The enzyme-linked immunosorbent assay (ELISA) has proven itself to be the most reliable method, with the help of which it is possible to identify different kinds immunoglobulins - IgM and IgG.

Immunoglobulins are protein compounds that are synthesized in blood cells. They react sensitively to the presence of infectious agents in the body, immediately forming an inextricable union with them.

Immunoglobulins type M (IgM) appear in the host’s body 4 to 7 weeks after the virus enters. Their number begins to gradually decrease as the body's immune response develops, while at the same time the concentration of immunoglobulins type G (IgG) increases.

Thus, in the certificate of test results, a pregnant woman can expect one of the following options:

IgM was not detected, and IgG was within normal limits;
No IgM detected, IgG exceeds normal indicators(positive IgG CMV infection in the expectant mother);
IgM is higher than normal.

What does this mean? In the case of the first test result, the pregnant woman’s body did not have contact with the dangerous virus, so all she now needs to do is strictly adhere to preventive measures and take care not to get infected.

The second analysis contains information that the woman’s body was in contact with cytomegalovirus, which, apparently, was in a passive form. This means that, fortunately, the initial infection did not occur, but there is a high risk of reactivation of the virus. The expectant mother needs to carefully monitor her health and boost her immunity in every possible way.

The results of the third analysis are the most unfavorable: a woman expecting a baby has had a primary infection or is about to show signs of reactivation of the virus, which has been in the body in a latent form all this time.

However, in some cases the situation becomes more complicated when, for some reason, the IgM compound is not detected analytically. Based on this, doctors first of all take into account the indicators of IgG, the level of which in different women different. In order for a specialist to have the opportunity to establish the norm of CMV during pregnancy, the appropriate analysis must be completed before conception. The fact that a viral reaction is unfolding is indicated by an IgG level that is 4 or more times higher.

Treatment of CMV during pregnancy

Having studied the specifics of CMV infection, it is not difficult to guess that there are no pills that permanently free the human body from the virus, so all treatment comes down to relieving the symptoms of the infection and keeping the virus in check (in an inactive form).

It is advisable for an expectant mother who is a carrier of the virus to take multivitamin complexes, pharmacy vitamin herbal preparations and, of course, immunomodulators to increase the body's defenses. This approach is relevant when the infection in a pregnant woman is passive. The drugs that the doctor prescribes to the woman are intended to prevent the development of the active form of cytomegalovirus.

If the CMV infection “woke up” and began to pose a real threat to the health of the pregnant woman and the fetus, in addition to vitamins and drugs that enhance immunity, the expectant mother will be prescribed antiviral medications. In this case, it is important to prevent the development of complications for which to the born baby there will be a heavy price to pay.

With an active form of cytomegalovirus, the expectant mother is prescribed intramuscular injections of anti-cytomegalovirus immunoglobulin, provided that the pregnancy does not exceed 6 weeks. To maintain immunity, drugs such as Rovamycin, Immunoflazid, Engistol, Betadine, Vilprofen can be used.

During treatment, you need to keep in mind that cytomegalovirus can cause other diseases that complicate a woman’s condition (for example, ARVI or pneumonia). If this happens, the concomitant disease must be treated no less actively than the CMV infection itself - this is the only way to eliminate the danger to the mother and her baby and to ensure that CMV returns to a passive form, bringing it under the control of the immune system.

In consultation with your doctor, experience can be used in the treatment of cytomegalovirus infection. traditional medicine. To strengthen the immune system, calendula, St. John's wort, lemon balm and rose hips are suitable. These plants are brewed and drunk as tea with the addition of a spoonful of honey (optional). Such drinks are especially useful if the expectant mother has been warned about the threat of spontaneous miscarriage.

How to protect yourself from cytomegalovirus

Despite the prevalence of the infection, not all people are carriers of the dangerous virus. Healthy woman A woman expecting a baby must responsibly observe a number of preventive measures that will help her protect herself and her child from possible infection. By the way, these same rules are also relevant for those expectant mothers who were unable to avoid contact with cytomegalovirus, and the infection “sleeps” in their body.

Casual sex is taboo for a woman, especially for one who is expecting a baby. Mandatory use of contraceptives in intimate relationships – reliable way protect yourself from cytomegalovirus and other sexually transmitted infections.
Careful adherence to the rules of personal hygiene and keeping your home clean are common truths that are instilled in a person from childhood. Following these rules increases a pregnant woman's chances of avoiding contact with harmful microorganisms. Now is not the time to take risks and use someone else’s dishes or towels - the expectant mother should have all things for individual use. In addition, wherever a pregnant woman is, she should always keep her hands clean. They need to be washed before sitting at the dinner table, after visiting the toilet, after being in public places, and after contact with money.
It's time to strengthen your immune system and acquire some healthy habits. healthy image life: master the basics of hardening, don’t be lazy and do special gymnastics for pregnant women, spend more time outside the city and breathe clean air. The body's strong defenses will keep the cytomegalovirus on a “short leash.”
Proper nutrition, healthy and balanced, is the main point in a pregnant woman’s health program. Fresh vegetables and fruits, cereals, lean meat, fish, high-quality dairy products - such a diet will provide the expectant mother with a powerful charge of energy, and will give her baby the opportunity to fully develop. A sufficient amount of vitamins and nutrients are the main requirements for food that will appear on a pregnant woman’s plate. Unless specifically prescribed by a doctor, you should never go on a restrictive diet during pregnancy.
The ideal option for replenishing the family would be to plan conception in advance, when CMV infection can be detected laboratory way. Both future parents must undergo the examination.

We remind you once again that cytomegalovirus does not promise anything good for the mother and her baby - sometimes the infection does not leave the child any chance of survival or healthy life. In order not to overlook the danger, if symptoms similar to a cold occur, the expectant mother should definitely seek advice from her doctor.