Chlamydia during pregnancy - chlamydia during pregnancy. Treatment of chlamydia during pregnancy, consequences. Chlamydia during pregnancy: how to fight the insidious infection and not harm the baby

Many pregnant women are often surprised when they see mandatory testing for sexually transmitted infections in appointments. After all, the pregnancy is going well and there are no symptoms of these diseases. Unfortunately, it is precisely such infections that affect the course of pregnancy, the birth of a woman and, most importantly, the well-being of the newborn. Chlamydia is also no exception to the rule.

The consequences are serious and can even lead to the death of the fetus in the womb.

General information about the disease

Chlamydia is infectious disease which is caused by chlamydia. Microorganisms simultaneously have the properties of bacteria and viruses, so they have a specific development cycle. Infectious agents can exist both in the cells of the reproductive system themselves, causing their inflammation and destruction, and outside the cells. The presence of chlamydia in the genitourinary system leads to the emergence and development of adhesions and significantly depletes a person’s immunity, which is unacceptable at the stage of waiting for a baby.

Treatment of the disease with antibiotics is not always effective due to the dual characteristics of the pathogen. In addition, the disease initial stage passes without symptoms and, if left untreated, quickly becomes chronic.

It often happens that incorrect or insufficient therapy leads to the disease developing as a persistent (“dormant” form). The infection subsides for a while and becomes more active during the period of influenza, bronchitis and other viral and colds when the body's defenses are weakened. The immune system of a pregnant woman “shares” its defenses with the baby’s body and works somewhat differently than usual. Therefore, chlamydial pathogens in the body expectant mother feel free and have a negative impact on the health of the woman and baby.

Possible consequences of chlamydia during pregnancy

Chlamydia during pregnancy is considered a health hazard. Gynecologists emphasize that in practice they rarely encounter normal pregnancy and childbirth without complications in women with this diagnosis. In addition, problems arise with the health of the mother and newborn. But in cases of a competent approach to the management and treatment of such a contingent of pregnant women, a favorable outcome occurs in 95% of cases.

Consequences for a pregnant woman

The pathogens feel best in the tissues of the woman’s genital organs, and they also often penetrate the lower intestinal tract. During pregnancy, microorganisms infect the amniotic fluid and the fetus itself. The serious complications that they provoke in the body of the expectant mother include:

• miscarriage, that is, a miscarriage that occurs at any stage of pregnancy. Moreover, a woman who has had chlamydia before may experience miscarriages in all subsequent pregnancies. A previous infection in a woman causes endometriosis, as a result of which the fetus is unable to firmly attach to the uterine wall. Gynecologists note that chlamydia is considered one of the causes of ectopic pregnancy. A fertilized egg cannot implant in the uterus, so it develops nearby - in the fallopian tube, which dooms it to death;
• various inflammatory pathologies of organs located in the pelvis. Harmful bacteria invade the uterus and appendages, thereby causing local inflammation. Among them, doctors often note salpingitis, endometritis, salpingoophoritis;
• Chlamydia is the cause of Reiter's disease. This is a serious ailment with a combination of diseases such as urethritis, conjunctivitis, arthritis;
• changes in the structure of the urethra - it narrows due to the appearance of adhesions and scars, so urination in expectant mothers is painful, and further ignoring the treatment of chlamydia leads to the appearance of cystitis.

During childbirth, the consequences of the inflammatory process are premature birth amniotic fluid and weak labor activity, which threatens problems for both the mother and the newborn.

Consequences of the disease for the child

Infection of a child during conception (if the expectant mother became infected with chlamydia before pregnancy) or in the first weeks of expecting a baby leads to serious and sometimes irreversible health problems little man. The most tragic outcome is miscarriage or intrauterine cessation of fetal development. The inflammatory process in the uterus and placenta provokes their abnormal activity, which leads to insufficient oxygen supply to the baby. Moderate hypoxia is the cause of pathological development of children's internal organs and systems. Significant hypoxia invariably leads to fetal death.

What else for the baby:

• The pathogens of the disease penetrate into the amniotic fluid, which the baby swallows during the process of growth and development, as a result of which the normal development pancreas, stomach, liver and kidneys;
• chlamydia affects the fetus’s ability to obtain the necessary nutritional components, so newborns infected with pathogens are born with low weight, lack of vitamins and anemia;
• a child becomes infected during labor activity women - chlamydia penetrates the mucous membranes of the child during passage through the birth canal. After some time, the disease manifests itself in the form of acute conjunctivitis, inflammation of the bronchi and lungs, and convulsions.

Other consequences of the disease for the child include muscle tone in varying degrees of severity and complex disorders of the nervous system.

Pediatricians diagnose such newborns with Fitz-Hugh-Curtis syndrome, which manifests itself as perihepatitis with complicated peritonitis and ascites.

In case of timely diagnosis of chlamydia in the expectant mother, as well as proper treatment of the disease, in most cases, the adverse effects of bacteria on the health of the newborn baby can be avoided.

Will pregnancy be normal after chlamydia?

Many young women are interested in whether it is possible to get pregnant and carry a healthy baby after suffering from an illness. Inflammation causes serious harm to the female reproductive system. The infection disrupts the normal functioning of internal organs, but may not cause any symptoms. However, a timely diagnosis and complete treatment of the disease allows a woman to become healthy. Chlamydia therapy should not be carried out during pregnancy, but at the planning stage. At the treatment stage, it is necessary to wait until conceiving a child, and a few months after taking the necessary medications, you can begin to implement your plans.

Treatment of infection while expecting a baby

In cases where the disease was diagnosed already at the stage of pregnancy, doctors do not recommend interrupting it. However, mandatory treatment is required. Modern medicine has many effective methods of treating infection that will not harm the mother and child.

Statistics show that women with chlamydia also experience other sexually transmitted infections. The expectant mother is being examined for the presence of herpes, syphilis, HIV, and cytomegalovirus. Research is carried out on the basis of blood tests and secretions from the genital tract. After a full examination and receipt of the results of the relevant tests, the doctor prescribes adequate treatment that will not harm the well-being of the expectant mother and baby. Based on identified infections, other diagnosed diseases and general health, the gynecologist prescribes antibiotics approved during pregnancy (Levofloxacin and the latest generation macrolides), immunomodulators, and special enzymes that help destroy microorganisms. After completing the course of treatment, the doctor recommends taking medications that help improve immunity. Each case requires an individual approach and the appointment of a specially selected treatment regimen that minimally affects the fetus.

Doctors warn that during pregnancy it is dangerous to self-medicate chlamydia, especially since the symptoms of the disease are inherent in other infectious diseases of the genitourinary system and require different therapy.

If chlamydia progresses in the urinary tract during pregnancy, an unpleasant disease called chlamydia develops. Conservative treatment must be immediate, otherwise, along with internal discomfort in the body, serious complications arise. The main goal of intensive care is to destroy pathogenic bacteria, suppress the unpleasant symptoms of chlamydia, and eliminate health complications for the unborn child.

What is chlamydia

If the genitourinary system is affected, doctors do not rule out increased activity of chlamydia in the urinary tract. Such causative agents of chlamydia are neither viruses nor bacteria, but also provide complete or partial intoxication of the body. Chlamydia are microscopic pests that choose germ cells as their habitat. They are larger in size than bacteria, but like viruses they can exist outside the human body. Since a woman’s immunity is weakened by pregnancy, the risk of infection increases several times.

Why is chlamydia dangerous during pregnancy?

If chlamydia is not treated promptly, the health consequences for the expectant mother may be irreversible. Increased activity of chlamydia trachomatis (Chlamydia igg trachomatis) causes placental insufficiency, fetal hypoxia, intrauterine growth arrest, pathological birth. If infection occurs early, doctors do not rule out a miscarriage. Chlamydia during pregnancy is dangerous because pathogens penetrate the systemic bloodstream, from where they enter the placenta and the child’s body. Doctors diagnose the following complications:

• Reiter's disease;
• abnormal narrowing of the urethra;
• female infertility;
• endometritis, salpingitis;
• inflammatory processes of the pelvic organs.

Symptoms of chlamydia during pregnancy

It is important to know what can cause the inflammatory process and the dangers of such a dangerous condition. This is a motivation to immediately seek the help of your doctor if severe symptoms of chlamydia appear during pregnancy. At first, a woman experiences internal discomfort, but does not understand its origin. Over time, the focus of the pathology becomes more pronounced, and the following changes are observed in the body:

• itching in the vagina;
• pain when urinating;
• vaginal discharge yellow color and unpleasant odor;
• pain in the lower abdomen;
• intermenstrual bleeding;
• inflammatory process;
• menstruation disorder.

Causes of chlamydia during pregnancy

Chlamydia and pregnancy are compatible concepts, since during pregnancy a woman’s immunity is weakened. The influence of pathogenic factors immediately causes an unpleasant infection with further symptoms of chlamydia. In order to prevent pathogenic flora from developing, it is important to know all the causes of chlamydia during pregnancy and eliminate them in a timely manner. In a typical disease, these are the following provoking factors:

• exposure to pathogenic flora in the form of chlamydia;
• infection from a sexual partner;
• failure to comply with personal hygiene rules;
• hypothermia or overheating of the body;
• long-term use of antibiotics;
• Women are at risk based on gender;
• the presence of other diseases of the genital area.

Consequences of chlamydia in pregnant women

Chlamydia is difficult to eradicate from the body, so treatment is long and not always successful. With timely and adequately selected therapy, there are no consequences of chlamydia in pregnant women. IN otherwise in the early stages of pregnancy, doctors do not rule out a miscarriage, and in the third trimester - premature, pathological birth. The impact of chlamydia on the body is always destructive, but the final result depends on the spread of pathogenic flora. Chlamydia during pregnancy requires treatment, and the doctor can prescribe antibiotics only after the patient has undergone tests.

Is it possible to get pregnant after chlamydia?

A woman should approach the issue of pregnancy planning responsibly. It is important to pass the required tests on the composition of the vaginal microflora, to exclude the presence of infectious and sexually transmitted diseases that are dangerous for intrauterine development. Pregnancy with chlamydia is possible, but its premature pathological outcome cannot be ruled out. Therefore, the first thing doctors recommend is to undergo thorough treatment, and then think about replenishing the family.

It is possible to become pregnant after chlamydia, but pre-treatment should apply to both sexual partners to avoid re-infection. Since the intensive therapy regimen contains antibiotics, it takes time for the synthetic components to finally leave the woman’s body. Taking extra vitamins won't hurt.

Consequences of chlamydia during pregnancy for a child

If the disease was identified already in “ interesting position“, it is necessary to undergo treatment. It is important to understand that simultaneous infection of mother and child occurs, which is fraught with serious consequences for their health. In the early stages of pregnancy, the baby may die, and if infected in the third trimester, the baby may be born ahead of schedule with extensive pathologies. In some clinical pictures, a disabled person is born. Alternatively, the following consequences of chlamydia during pregnancy for a child cannot be ruled out:

1. Against the background of intrauterine oxygen starvation in children's body increased intracranial pressure, problems with the nervous system appear.
2. Lack of nutrients in prenatal period can provoke a delay in the development of internal organs, mental retardation, and the birth of a child with a relatively low weight.
3. Since the baby passes through an infected birth canal, even with caesarean section is born with chlamydia. The consequences are diseases such as conjunctivitis, rhinitis, colpitis, pneumonia, extensive damage to the liver, kidneys, stomach and lungs.

Diagnosis of chlamydia

The presence of the disease can be determined by pronounced symptoms, and the nature of the pathogenic flora - by analysis, laboratory research. Diagnosis of chlamydia during pregnancy includes an integrated approach to the health problem. For example, a doctor must collect biological material from the cervix, which is subsequently examined under a microscope. If a woman has already had chlamydia, a laboratory method can detect specific antibodies. Additionally, it is necessary to collect amniotic fluid and assess the condition of the fetus.

Chlamydia smear

A high concentration of chlamydia is observed in the cervical canal and cervix. Therefore, a characteristic smear for chlamydia becomes the most informative diagnostic method; it determines with maximum accuracy the nature of the pathogenic infection and the degree of neglect of the pathological process. After receiving the results of the study, a consultation with a gynecologist is necessary. The doctor will tell you how to quickly and permanently eliminate chlamydia in pregnant women with reduced immunity.

Blood analysis

Since immune cells fight pathogenic flora, antibodies produced to chlamydia DNA can be detected in the red biological fluid. For the expectant mother, this is confirmation that chlamydia is developing in the body. Therefore, a blood test for chlamydia during pregnancy is effective method diagnostics, which will help to quickly detect pathogenic flora and immediately begin to eliminate it. Modern medicine has announced several intensive therapy regimens that will quickly bring a pregnant woman’s condition back to normal.

Treatment of chlamydia during pregnancy

After determining the nature of the pathogenic flora, taking into account the amount obstetric weeks the doctor prescribes intensive antibacterial therapy. The purpose of taking antibiotics is to disrupt the integrity of chlamydia membranes, paralyze their DNA and prevent rapid reproduction in the reproductive system. The choice of medications is carried out individually, but the following antibiotics have proven themselves to be effective:

• Doxycycline;
• Chemomycin;
• Clubax;
• Rulid;
• Azithromycin;
• Macropen;
• Klacid;
• Erythromycin;
• Amoxiclav;
• Ceftriaxone;
• Amoxicillin;
• Unidox Solutab;
• Flemoxin Solutab;
• Sumamed;
• Clarithromycin;
• Rovamycin.

It is important to clarify that chlamydia in women during pregnancy can be treated with antibiotics for more than 16 obstetric weeks, when the placenta has finally formed and protects the fetus from negative influence factors provoking the disease. Intensive therapy should apply to both sexual partners, otherwise the absence of unpleasant symptoms is temporary. Conservative treatment of chlamydia during pregnancy lasts 10-14 days, but after a couple of weeks of break it is recommended to resume the antibacterial course.

To avoid the detection of dysbacteriosis as a result of intensive therapy, taking probiotics is additionally indicated. Carrying out symptomatic treatment is an auxiliary measure to as soon as possible restore a woman’s health, strengthen the immune system, protect the fetus during intrauterine development. To restore cells damaged by toxic enzymes, you should take immunomodulatory drugs according to medical indications. After completing the antibacterial course, to check the body’s reaction, the doctor prescribes a repeat culture for pathogenic flora.

Prevention

To avoid detection of chlamydia in the blood during pregnancy, it is necessary to take a responsible approach to the period of planning for future offspring. If treatment is carried out in a timely manner, there will be no complications or chronic chlamydia. When a woman knows only by hearsay about the course of the disease, she must take care to comply with special preventive measures. For example, sex with casual partners is excluded; it is important to be selective about your sex life. Other measures to prevent chlamydia during pregnancy are presented below:

• systematic observance of personal hygiene rules;
• daily douching with decoctions of chamomile and string;
• timely examination with a sexual partner.

Video: Chlamydia in pregnant women

What causes the disease

Chlamydia can also be transmitted to living conditions. This route of transmission accounts for no more than 5% of infections. During pregnancy, chlamydia penetrates the amniotic fluid and then affects the fetus. Infection is promoted by ingestion of amniotic fluid.

possible, but the disease must be cured before conception. This is the only way a woman will have every chance of giving birth healthy child. During pregnancy planning, it is necessary to undergo appropriate tests. If pregnancy has already occurred, such an examination is included in the standard management scheme. Chlamydial infection is currently treated without any consequences for the unborn child.

Bacteria enter the human body through close contact with the mucous membranes of an infected person. After some time, they infect immune and epithelial cells, where they remain for 3–5 years. After a few days, the human immune system recognizes the infectious agent and begins to produce. As a result, an acute inflammatory process occurs. Its intensity may vary.

How does infection manifest during pregnancy?

In most cases, the disease occurs in a latent form. This is why chlamydia is dangerous. More than half of women do not know that they are infected. In other cases, chlamydia has mild symptoms:

The signs described above may indicate not only chlamydia, but also other infections of the genitourinary system. There are no typical signs to help recognize the disease. However, this is not a reason to refuse the examination. Availability of the above discomfort should force a woman to see a doctor.

How dangerous is the disease?

At improper treatment chlamydia has negative impact on the body of a woman and her unborn child. Against the background of this infection, an inflammatory process develops in the pelvis, which can result in peritonitis. - one of the most common complications of chlamydia. This affects the joints and organs of vision. The narrowing of the urethra contributes to disruption of urine excretion processes.

Increased muscle tone is one of the least dangerous complications found in a child born to a mother with chlamydia. In other cases, severe damage to the central nervous system is detected. With pronounced hypoxia, the child is born dead. The consequences for the child may include nutritional deficiencies. The fetus has low weight and signs of iron deficiency anemia.

In the later stages, chlamydia enters the child's body. Most often, damage to the digestive and excretory systems is detected. The risk of death depends on the severity of the disease. Timely treatment can help reduce the risk of complications.

Congenital chlamydia in children manifests itself:

• conjunctivitis;
• pneumonia;
• encephalopathy;
• convulsive syndrome.

Most dangerous consequence Chlamydia is considered to be Fitz-Hugh-Curtis disease, which combines hepatitis, ascites and peritonitis.

How is the disease diagnosed?

It is not difficult to detect chlamydia in the blood during pregnancy at this stage of medical development. Immunological and serological tests can detect both the infectious agent itself and antibodies to it. First, a swab is taken from the vagina, cervix or urethra. At positive result blood analysis is performed.

In certain cases, it is necessary to know whether the fetus is infected. For this purpose, amniotic fluid is taken. Pregnant women are wary of this procedure, but it is not considered dangerous to the unborn child. The material is collected under ultrasonic control. There is a certain risk, but it is assessed as insignificant. Amniocentesis allows you to detect the disease in time and protect the child from it. negative consequences.

Therapy

Treatment of chlamydia during pregnancy begins with identifying concomitant infections, which are no less dangerous than the underlying disease. It is necessary to carry out tests for:

• syphilis;
• ureaplasmosis;
• herpes;
• cytomegalovirus.

Based on their results, a comprehensive therapeutic regimen is drawn up. Equally important is the diagnosis of non-communicable diseases, such as renal or liver failure. The use of drugs can negatively affect the general condition of the body and disrupt the functions of internal organs.

Therapy should be carried out under the supervision of the attending physician. You should not stop it after the symptoms of the infection disappear. Chlamydia remaining in the body develops resistance to the antibiotic used, which makes complete elimination of the disease almost impossible. Not all drugs used to treat chlamydia are suitable for pregnant patients. For example, tetracycline antibiotics, which have a large amount of side effects. Macrolides are the safest.

Taking medications on your own is strictly prohibited. Only an experienced specialist can select the safest medications for mother and child.

May involve a single dose of a drug to which chlamydia is hypersensitive. Complex therapy includes taking enzymes and immunostimulants. All medications are selected taking into account the characteristics of the body, the duration of pregnancy and the presence of certain symptoms. Immunomodulatory drugs are not always used. The need to take them is determined by the results of the immunogram.

Enzymes play an important role in eliminating chlamydial infection. With their help, the permeability of cell membranes is normalized and the risk of developing allergic reactions for drugs. In addition, enzymes have analgesic and anti-inflammatory effects. To determine the effectiveness of treatment, control tests are performed.

Preventive measures

It implies the refusal of casual intimate relationships and the use of barrier methods of contraception. A condom should also be used when a woman is not sure about the health of her husband. Regular testing for chlamydia is necessary. The disease during pregnancy is not uncommon; it is found even in women living in normal social conditions.

While expecting a child, a pregnant woman can face a variety of dangers. Unfortunately, during pregnancy the female body becomes most vulnerable. Therefore, the expectant mother may even encounter diseases that have never bothered her before. The topic of our conversation today will be the problem of chlamydia and pregnancy.

Chlamydia is a very insidious disease. Numerous clinical studies have reliably shown that the presence of chlamydia in a woman has a very negative effect on the reproductive system. Firstly, chlamydia can most likely lead to the development of infertility. Well, if an expectant mother suffers from chlamydia, it can cause infection of the child and even termination of pregnancy.

What is chlamydiaand where does it come from?

Chlamydia - very interesting creatures, which have the characteristics of both bacteria and viruses. In size, chlamydia is many times larger than bacteria, but smaller than viruses. Another common feature with chlamydia viruses is that they can only exist inside cells. Outside the host's body, they simply die. This happens due to the fact that chlamydia cannot produce energy on its own - they receive it from the cells of the host body.

Chlamydia feels most comfortable in the cells of the human genital organs. And therefore, chlamydial infection most often affects a woman’s genitourinary system. In more rare cases, chlamydia can be localized in the epithelial tissue of the lower small intestine. By the way, most often this happens if a person has dysbacteriosis. In a pregnant woman, chlamydia often affects not only the genital and urinary tract, but also the membranes and the baby itself.

The source of infection is a person with chlamydia. It is very important to remember that chlamydia can be very long time proceed without any symptoms. And even the “carrier” of the disease himself may not realize that he poses a potential danger to his sexual partner.

Chlamydia is a typical representative of a classic sexually transmitted infection. And accordingly, as you might guess, the route of transmission is sexual, through unprotected sexual intercourse. Using condoms reduces the risk of transmission to some extent.

There is a possibility of infection with chlamydia through household means, through contaminated hygiene items - towels, washcloths, etc. Although such methods of infection account for no more than 5% of all cases of the disease, it is impossible to forget that all personal hygiene items should be personal.

During pregnancy, another method of transmission of chlamydia appears - “vertical”, from the reproductive tract of the mother to the fetus. As mentioned above, during pregnancy chlamydia penetrates the amniotic fluid and then affects the fetus itself. Infection of the fetus occurs due to the fact that the baby constantly swallows small amounts amniotic fluid. In addition, the infection can settle on the mucous membranes of the fetus.

Chlamydia during pregnancy is not such a rare occurrence. It occurs in approximately every tenth expectant mother. Moreover, chlamydia often occurs in women with an uncomplicated pregnancy, good general health and social status. Therefore, no woman should lose sight of this danger - the problem of chlamydia can affect absolutely any expectant mother.

Well, if a woman has previously had infertility, inflammatory processes of the appendages, and especially miscarriages, the risk that she will have chlamydia exceeds 65%. As a rule, doctors always pay close attention to this factor. The woman is sent for an examination to confirm or deny the presence of chlamydia in her body. If necessary, appropriate treatment is prescribed.

Moreover, it is much wiser to undergo examination in advance, even before pregnancy. This will avoid many unnecessary worries and unpleasant moments associated with the treatment of the disease. But even if the pregnancy did not occur as planned, do not despair - modern medicine makes it possible to cure the expectant mother without any negative consequences for the baby’s health.

Mechanism of infection

It is impossible not to say a few words about how exactly infection occurs. In close contact with the mucous membranes of the carrier, chlamydia infections penetrate the mucous membranes healthy woman. After a short time, chlamydia begins to invade epithelial cells and cells of the immune system. In these cells, chlamydia can exist for a very long time - up to 3 - 6 years.

After about two days, the immune system comes to its senses. And it begins to respond adequately - to produce leukocytes. As a result, an inflammatory reaction develops, the intensity of which can vary from mild to pronounced. If the problem is not noticed immediately, a pathological structural change in the tissue affected by chlamydia is possible.

Exactly these pathological changes tissues and are the main complication of chlamydia. In the event that the disease overtook a woman before pregnancy, damage to the ovaries and fallopian tube with a high degree of probability can lead to infertility. And during pregnancy, the favorite habitat of chlamydia is the cervix. And, of course, a chronic inflammatory process cannot occur without complications - it can lead to premature termination of pregnancy or premature birth.

Infection of the baby is no less dangerous. Chlamydia crumbs cause much more harm to the body - there is a high probability of malformations of the child’s internal organs. And sometimes it’s even possible fetal death fetus

Symptoms of chlamydia in pregnant women

Symptoms of the disease may vary. And in many ways they depend on what stage of development the infection is at and where the inflammatory process is localized. If chlamydia is localized in the urethra, we are talking about chlamydial urethritis. The following symptoms are observed:

• Discharge from the urinary canal

In some cases, it may appear small quantity discharge from the urethra. These discharges are usually slightly cloudy and have white shade. In case of severe inflammation, they may contain an admixture of pus.

• Discomfort when urinating

As the disease develops, very often a burning or stinging sensation appears during urination, as with cystitis. These sensations sometimes give a sick woman many unpleasant minutes - every trip to the toilet becomes an ordeal. And pregnant women, as you know, go to the toilet very, very often due to their physiological characteristics.

• Pain in the abdomen

The inflammatory process cannot but affect the condition Bladder. As a result, a woman may experience a feeling of heaviness and pain in the lower abdomen, in the bladder area.

Although this type of disease is quite rare. Much more often occurs cervicitis - chlamydia of the cervix. Development of the inflammatory process in in this case occurs in the cervical canal. As a result of this, the cervix swells quite strongly and increases in size. If the process lasts a long time, the normal structure of the cervical epithelium is disrupted. As a result, cervical erosion may develop.

And for pregnant women, the typical location is the vaginal mucosa. This phenomenon is called chlamydia colpitis. In addition, sometimes chlamydia can be located in the glands located near the vagina. This localization of colpitis is explained by hormonal changes in a woman’s body.

However, we must not forget that urogenital chlamydia can very often be completely asymptomatic. That is why monitoring a pregnant woman and routine examination mandatory includes tests for the presence of chlamydia. In no case should you ignore visits to the doctor and examinations prescribed by him. After all, a timely detected problem significantly increases the chances of a successful recovery and a normal course of pregnancy.

More about the danger

I would like to once again talk in more detail about exactly what danger chlamydia poses to a baby. And we will begin the story about chlamydia infection on early stages pregnancy. The most important complication is spontaneous termination of pregnancy, or intrauterine arrest of fetal development. This happens largely due to the fact that chlamydia causes very severe placental insufficiency.

As you might guess, placental insufficiency inevitably entails a disruption in the child’s adequate oxygen supply. And a lack of oxygen is nothing more than hypoxia. And you don’t need to have special medical knowledge to guess what it threatens the child with.

It all depends on the severity of hypoxia. If it is expressed moderately, then damage to various systems and organs is possible, from mild to pronounced. IN best case scenario the baby will be born with a lung muscle tone, and in the worst case – with severe damage to the nervous system. Well, if the hypoxia turns out to be too strong, the development of pregnancy may stop altogether - the child will simply die in the uterus.

And the results of disruption of the baby’s supply of nutrients are also very disastrous. In the case of a mild disorder, the child is born with iron deficiency anemia, vitamin deficiency, and very low body weight. All these complications of chlamydia most often develop in the first and second trimester of pregnancy.

In later stages of pregnancy, the most common complication is infection of the baby itself. As a result of this process, they are often affected internal organs child - most often this concerns the kidneys, liver and pancreas. The threat to the health and life of the baby depends on the degree of damage. But in any case, treatment must begin as early as possible. This measure will help reduce harm to the child's health.

Diagnosis of chlamydia during pregnancy

Many women often ask - how did our mothers give birth to children without even hearing about chlamydia? Wasn't it there before? Of course he was. But, unfortunately, that level of medicine did not allow identifying chlamydia and diagnosing the disease. And all cases of spontaneous abortion, arrest of fetal development and congenital diseases of the fetus remained with the wording “unclear etiology (origin)”.

Fortunately, today there are enough a large number of types of immunological and microbiological studies. The study is completely simple and will not bring the woman any discomfort. First, it is necessary to collect biological material, which will subsequently be carefully studied.

Biological material is discharge from the vagina, cervix and urethra. To do this, completely painless smears will be taken from the expectant mother. Remember that when going to see a doctor, you should not douche. Otherwise, the results of the study may be incorrect.

In some cases, it becomes necessary to determine whether the baby is infected. For this purpose, it is necessary to collect amniotic fluid. As a rule, expectant mothers are usually very scared. And indeed, there is still some risk. But it is extremely small, since the entire procedure is carefully monitored by ultrasound monitoring of the doctors’ manipulations and the condition of the baby. And the doctor will never prescribe it if the possible risk is higher than the possible benefit. Therefore, you should not refuse to study amniotic fluid. Often, this procedure allows you to identify the problem in a timely manner and save the baby not only health, but sometimes even life.

Treatment of chlamydia in expectant mothers

As you can already see for yourself, pregnancy and chlamydia are not the best allies. This means that it is necessary to get rid of chlamydia as quickly as possible. Treatment of chlamydia is in many ways significantly complicated by the situation of the woman - after all, not all medications can be used by pregnant women.

Chlamydia penetrates into the cells of the genitourinary system of the expectant mother and is located there. And only antibacterial drugs can destroy them. As a rule, antibiotics from the tetracycline group are very successful against chlamydia. But this treatment, even in non-pregnant women, causes an extremely large number of various side effects and complications. What can we say about expectant mothers? Moreover, this group of antibiotics has a very negative effect on the baby’s body and that is why it is prohibited for use in pregnant women.

Therefore, today the most modern antibiotics belonging to the macrolide group are used to treat chlamydia in pregnant women. For obvious reasons, we will not give the exact names of the drugs, much less the dosage, within the framework of this article. Moreover, this is impossible to do. All medications are selected by the attending physician, strictly individually and taking into account all the characteristics of the course of pregnancy and the woman’s illness.

But for successful treatment of chlamydia it must be comprehensive. In addition to taking antibacterial drugs, the doctor will necessarily prescribe medications that will eliminate the existing intestinal and vaginal dysbiosis, which is an invariable companion of chlamydia. In addition, it would be useful to carry out a course of treatment aimed at correcting and stimulating the functioning of the immune system.

But remember that the immune system of a pregnant woman is an extremely complex issue. Therefore, all decisions regarding this issue should be made by an immunologist, together with a gynecologist who monitors the course of the sick woman’s pregnancy. As a rule, timely and comprehensive treatment of chlamydia brings very good results.

Treatment of chlamydia with folk remedies

There are several quite effective folk recipes for the treatment of chlamydia, which can also be used by pregnant women. They will not have any negative impact on the health of the expectant mother, much less on the health of the baby. But, nevertheless, if the expectant mother decides to try any of them, it is still better for her to first consult with her gynecologist. And you shouldn’t forget about such a phenomenon as individual intolerance to one or another component.

• Garlic infusion

The amazing antibacterial property of garlic has been known to people for many centuries. No wonder garlic is used to treat colds and viral diseases. And in the treatment of chlamydia, garlic can also provide invaluable help. First you need to prepare an infusion of garlic.

It is prepared as follows. Peel 6 medium-sized cloves of garlic, chop and add one glass of hot water. Place in a warm and dark place for approximately 12 – 14 hours. After this, the resulting infusion must be filtered using gauze. Don't forget to squeeze out the pieces of garlic - they contain a large amount of useful biologically active substances.

Mix the resulting solution with one tablespoon of honey, mix thoroughly and leave for another hour. The resulting infusion must be used for douching. The expectant mother should douche at least twice a day - in the morning and before bed. The course of treatment should not exceed 10 days.

Some sources advise eating two or three cloves of garlic in parallel with douching during the entire course of treatment. However, doctors warn that the expectant mother may experience heartburn due to garlic.

• Calendula

Calendula is very effective in such a situation. It not only has a detrimental effect on chlamydia, but also very effectively relieves inflammatory processes that inevitably arise as a consequence of chlamydia. For treatment, an oil infusion of calendula flowers and an ordinary infusion are used.

Take 50 grams of dry calendula inflorescences, chop them and place them in an enamel bowl. Pour calendula into a glass olive oil and bring to a boil over low heat. After the oil boils, turn off the heat and leave to steep for a day. Then strain using a gauze cloth and pour into a glass container. It is used as follows: thoroughly moisten the hygienic tampon yourself in an oil solution. small size and leave it overnight. This procedure must be carried out strictly after preliminary douching with calendula infusion.

And the decoction is extremely simple to prepare. Place 3 tablespoons of calendula inflorescences in a thermos and add one liter of boiling water. Cover tightly with a lid and leave to steep for a day. After this, carefully strain the infusion using a gauze cloth, heat it to a temperature of 37 - 38 degrees and add 2 tablespoons of honey to it. You need to douche twice a day - in the morning and before bed.

Prevention of chlamydia during pregnancy

We must also not forget about the prevention of chlamydia. In principle, prevention is very simple, but it’s still worth saying a few words about it:

• Maintaining personal hygiene

“Cleanliness is the key to health.” This simple truth is known to everyone from the cradle. And yet, very often this truth is neglected. Remember to wash your hands regularly, especially after using the toilet. And by the way, in public toilets, do not forget to use disposable toilet circles.

• Personal hygiene items

Never, under any pretext, use other people’s towels, washcloths, bed linen. And don't give yours either. Even people you know well whom you completely trust.

• Protected sexual intercourse

Do not forget about the need to use condoms during sex if you do not have a 100% guarantee of your partner’s health. Please note that no other means of protection against chlamydia will protect you.

And finally, it’s worth repeating once again - do not ignore timely visits to the gynecologist, take all tests and undergo all examinations. And then no chlamydia will be able to ruin the happiest months of your life - the months of waiting to meet your baby.

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Chlamydia is an absolute pathogen and cannot normally be present in human tissues and organs. The latent course of the disease allows pathogens to remain undetected for a long time. However, a thorough examination of women during pregnancy does not allow such dangerous infection. What is the most accurate test for chlamydia during pregnancy, what are the dangers of the disease and how to get rid of it?

There are about six to eight varieties of chlamydia, but two species are dangerous to humans - Chlamydia trachomatis and Chlamydia pneumonia. The latter is the cause of atypical pneumonia, including in pregnant women. But more often we have to deal with Chlamydia trachomatis, which lives in the genitourinary tract of men and women, and immune complexes to it can circulate in the blood. It is this type of chlamydia that is screened for during pregnancy.

What kind of pathogen

A peculiarity of microorganisms is their ability to transform into “dormant” L-forms. Moreover, they are located inside cells (most often of the genitourinary system), pass from one to another during division, but are not recognized in any way immune system person. And only under “convenient” conditions are they activated and cause clinical symptoms of inflammation.

The statement that chlamydia, like the herpes virus, is constantly present in the body, but is activated during special periods, is not entirely true. In the absence of treatment or non-compliance with regimens and doses, “hidden” forms continue to reside in human cells, creating the appearance of well-being. This is a chronic variant of the disease, but not a normal variant.

How is it transmitted?

The “favorite place” of chlamydia is the mucous membranes of the genitourinary tract. Therefore, the main route of transmission is sexual, including not only vaginal, but also anal and oral contact. The incubation period of infection can be up to two months; symptoms are most often extremely scarce.

In addition, contact and household transmission is possible through close contact with the secretions of other people. The greatest risk is associated with visiting baths and saunas. Infection through unwashed hands is also possible, and both a clinical picture of inflammation of the genitourinary system and conjunctivitis, including in children, can occur. Newborns can become infected from a sick mother when passing through the natural birth canal.

Before or during pregnancy

When chlamydia is detected during pregnancy, the question naturally arises as to when the infection occurred, which has not only clinical significance, but also social significance - this is a serious threat family relations. The algorithm is approximately like this. If the woman has previously been examined:

• chlamydia was detected- it is possible that the woman was poorly treated before pregnancy or the pathogens have passed into the L-form, as a result they can be detected again during pregnancy;
• there were no chlamydia- detection of microbes during gestation indicates infection during or after conception.

If a woman has never been tested for chlamydia before, it is impossible to indicate the time of infection, given that the disease can long years occur in an asymptomatic form. However, it should be borne in mind that in this case, chlamydia very often leads to tubal factor infertility - adhesions form and obstruction occurs.

Airborne transmission is typical only for Chlamydia pneumonia with the appearance of symptoms of acute respiratory disease. To become infected with Chlamydia trachomatis, contact with human biological fluids that contain the pathogen is necessary.

Manifestations of chlamydia during pregnancy

Most often, chlamydia is an “accidental” finding during a detailed examination of a pregnant woman. Sometimes the following facts are markers of the presence of infection:

• recurrent inflammation in the vagina- during examination, in ordinary smears, leukocytes are increased, gardnerella, yeast fungi are present, coccal flora predominates;
• signs of poor fetal growth- according to the results of ultrasound, growth retardation is observed for two or more weeks, there are symptoms of intrauterine infection;
• pathology of pregnancy- threats of miscarriage, chorionic detachment, leakage of amniotic fluid or premature birth- all this is an indication for additional/repeated examination for chlamydia.

First of all, chlamydial infection is localized in the vagina and cervix, especially if the infection occurred during pregnancy. Therefore, the following symptoms of chlamydia during pregnancy predominate in the clinic.

• Colpitis. The amount of leucorrhoea increases; it is light milky, without any special odor, reminiscent of “cream”. Itching, burning, and redness of the external genitalia may occur due to irritation from the discharge.
• Cervicitis. The woman does not feel inflammation of the cervix and cervical canal. However, when gynecological examination redness and increased tissue tenderness can be detected.
• Urethritis and cystitis. Chlamydia can manifest itself in the form of frequent and painful urination, pain in the lower abdomen due to inflammation of the bladder.
• Oral lesions. Chlamydia can also live on the oral mucosa. Clinical picture corresponds to gingivitis, glossitis, pharyngitis and is accompanied by pain, ulcers, unpleasant smell from mouth.
• Pneumonia . With a serious decrease in immunity, for example, due to HIV, atypical pneumonia with mild symptoms and radiographic signs are possible.

Other complications of chlamydia, such as trachoma (damage to the membranes of the eye), Reiter's disease (involvement of the joints) are more common in non-pregnant women.

Why is it dangerous?

Chlamydia is more dangerous for a child, as it can affect its normal development. For a woman, the risk of postpartum complications increases.

For the fetus

The main consequences of chlamydia during pregnancy for a child:

• in the early stages- freezing of embryo development, threat of interruption, chorion detachment; with chlamydia, the likelihood of developmental defects, as well as ectopic location, increases ovum(ectopic pregnancy in women);
• in later stages- retarded growth and development of the fetus, impaired functioning of the placenta, increases the likelihood late miscarriages, polyhydramnios, leakage of amniotic fluid and premature birth;
• after birth - every fifth baby born to a woman with chronic chlamydia develops eye inflammation (conjunctivitis), every tenth is diagnosed with atypical pneumonia, especially often such complications develop in premature babies.

In addition, intrauterine infection and inflammation of the placenta (chorioamnionitis) may occur, which can pose a threat not only to the life of the child, but also to the woman.

For woman

During pregnancy, chlamydia, in addition to the troubles associated with colpitis, is fraught with the development of conjunctivitis if personal hygiene is not observed. For a woman, untreated chlamydia is most often fraught with the following complications after childbirth:

• endometritis - inflammation of the uterine cavity, which is accompanied by a violation of its contractility and prolonged involution (recovery);
• seam dehiscence- the likelihood of suppuration of wounds of the vagina and perineum with subsequent poor healing increases.

If chlamydia is in a woman’s urinary system, after childbirth the frequency of cystitis, urethritis and even pyelonephritis increases. Ignoring the problem can subsequently lead to Reiter's disease (joint damage) and trachoma (eye disease).

What tests need to be taken

Considering the dangers of chlamydia during pregnancy, its diagnosis should be taken seriously. To identify and subsequently treat chlamydia, one type of examination is sufficient - polymerase chain reaction (PCR), preferably its variety - real-time PCR. The latter helps to make the study more accurate and eliminate overdiagnosis associated with the detection of “dead chlamydia”.

Polymerase chain reaction

PCR analysis can be taken at any time. The collection of material (scraping, better known as a “smear”, which is not entirely true) is carried out from the following places:

• urethra;
• cervix;
• posterior vaginal fornix.

The detection of even single microbes is considered positive. A negative result confirms the complete absence of chlamydia in the body.

Linked immunosorbent assay

The ELISA method is often used to diagnose chlamydia. The study involves collecting venous blood and determining antibodies to pathogens - Ig G and Ig M. The result can be interpreted using the following table.

Table - How to correctly understand the result of a chlamydia test

You can often encounter the fact that only if a positive Ig G (“chlamydia in the blood”) is detected during pregnancy, antibacterial treatment is prescribed according to the standard regimen. However, such an immune status may indicate a previous illness, and not an active infection.

Other methods

Chlamydia can also be suspected or detected by other methods, however, due to the high cost and length of research, they are used extremely rarely in atypical cases of infection.

The following tests may be used:

• immunofluorescence reaction (RIF);
• bacteriological culture.

A standard smear can only show the presence of inflammation in the vagina, urethra and cervix, but cannot identify the pathogen in this way.

What to do if detected

The question that treatment is necessarily not subject to doubt, however, only when it is confirmed. There are no doubts or debates here, as for example with mycoplasmosis or ureaplasmosis. Chlamydia is clearly classified as a pathogen and should not normally be detected. Absolute indications for starting therapy during pregnancy:

• detection of chlamydia by PCR;
• detection of Ig M in the blood during ELISA testing.

When to treat

The question of when to start treatment for chlamydia during pregnancy so that the medications do not have serious consequences for the development of the fetus remains debatable. It is generally accepted that starting antibacterial therapy is considered safe from 16-20 weeks. However, in the case of acute or complicated chlamydia (for example, against the background of a threat, hematoma), expectant management can lead to pregnancy loss.

It is impossible to cure chlamydia without antibiotics. But pregnancy imposes serious restrictions on antibiotic therapy. For example, Doxycycline and Ofloxacin are prohibited for treatment during pregnancy, as they cause disruption of the development of bones and teeth in the fetus. The table shows which products are acceptable for use.

Table - Approved drugs for the treatment of chlamydia during pregnancy

Depending on the period of time and in what situation the treatment is carried out, vaginal suppositories, as well as drugs to maintain pregnancy (for example, Duphaston), may be additionally prescribed. When treating chlamydia in a woman important point is the sanitation of the sexual partner. The regimens and doses of the drugs are similar. Sexual intercourse is possible only after a full course of therapy and control of cure.

Therapy control

There is no doubt about whether chlamydia can be treated during pregnancy. If all recommendations are followed, the infection resolves without significant complications for the mother and fetus. After treatment, it is necessary to monitor the cure. To do this, it is recommended that the woman and her sexual partner undergo a PCR test no earlier than a month after taking the last pill.

ELISA research in this case is not always informative. The effectiveness of therapy can be assessed by a decrease in antibody titers, but sometimes their level remains constant in the complete absence of infection.

What if you ignore

Some women refuse to take antibiotics during pregnancy, even if they have chlamydia. In these cases, they risk the baby’s health and their lives. Chlamydia in women in 70% of cases leads to various complications of pregnancy and infectious pathology newborn