Positive result for chlamydia during pregnancy. Treatment of chlamydia during pregnancy: when to start, what regimens and drugs are considered safe

How to treat chlamydia during pregnancy?

During pregnancy, almost any illness can cause serious concern and discomfort future mother. This is no exception pathological condition, How .

Chlamydia refers to a number of intracellular pathogens that can cause infectious diseases with various manifestations in animals and humans.

People are predominantly affected by 2 types of chlamydia, only one of which is sexually transmitted, provoking an inflammatory process in the genitourinary organs. This is chlamydia trachomatis.

Chlamydia enters the human body through close contact with the mucous surfaces of the carrier of the infection. After some time, they invade epithelial cells and immune cells. Pathogens can exist in them for quite a long time (up to 6 years).

This disease very often occurs with absolutely no symptoms. In approximately 67% of women there is no suspicion of infection. In other cases, the disease manifests itself in some way, but does not have obvious symptoms.

There may be mucous or mucopurulent vaginal discharge that differs from normal unpleasant smell or yellowish color.

In the area of ​​the external and internal genital organs, a pregnant woman may experience itching, burning and mild pain. Chlamydia can manifest itself as discomfort in the lower abdomen.

Before pregnancy, the disease may manifest itself as intermenstrual bleeding and increased pain before critical days. A slight increase in temperature and general weakness are also possible.

All of the above signs can be observed not only in the case of chlamydia, but also in any infection of the genitourinary system. There is no specific sign that will accurately determine the presence of chlamydia.

Why is it dangerous?

If treated poorly or untimely, chlamydia can cause serious complications.

How does chlamydia affect pregnancy?:

1. Pelvic inflammatory diseases. Pathogens can end up in the uterus, fallopian tubes and appendages, thereby causing an inflammatory process (endometritis, salpingitis, salpingoophoritis).
2. Reiter's disease, characterized by a triad of symptoms: conjunctivitis, urethritis and arthritis.
3. Urethral stricture, which means a narrowing of the urethra due to cicatricial changes in the urethral mucosa.

Infection of a pregnant woman early stages can cause dire consequences for the child and the expectant mother herself. The worst thing is stopping the development of the fetus inside the womb or miscarriage.

This occurs because the disease leads to placental insufficiency, which causes disruption in the baby’s oxygen supply. Lack of oxygen is called hypoxia. It can provoke serious consequences, which depend on the severity. Even a moderate lack of oxygen can cause damage to systems and individual organs.

In favorable cases, the newborn baby may have mild muscle tone. The most serious consequences can be severe damage to the nervous system. With severe hypoxia, the fetus will die.

Also, the influence of chlamydia can manifest itself as a disruption in the child’s supply of nutrients. In this case, there is a risk that he will be born with iron deficiency anemia, vitamin deficiency, and low body weight.

On later A child can be infected with chlamydia. Very often the infection affects the pancreas, kidneys, and liver. The harm can be reduced by treatment, which should be started as soon as possible.

Congenital chlamydia can manifest itself:

• chlamydial pneumonia;
• ophthalmochlamydia;
• encephalopathy and convulsions;
• Fitz-Hugh–Curtis syndrome(acute peritonitis and perihepatitis, which is accompanied by ascites).

Postpartum complications

After childbirth, usually from 2 to 6 weeks, a mother with chlamydia often experiences endometritis. Inflammatory phenomena are not pronounced.

The only sign of inflammation of the uterine mucosa is often a prolonged, but mild increase in temperature (low-grade fever) with slow reverse development of the uterus.

According to statistics, endometritis after childbirth is 300% more common in women infected with chlamydia than in cases of infection with other STIs. In addition, chronic chlamydia of the uterus and appendages (salpingoopharitis, endometritis) can further cause a decrease in the patency of the fallopian tubes, as well as cause infertility and ectopic pregnancy.

Diagnostics

It is not difficult to detect infections that cause this disease. Serological and immunological studies can detect chlamydia. First, the doctor collects biomaterial (discharge from the vagina, cervix, urethra).

Sometimes you need to find out whether the fetus has been infected. For this purpose, amniotic fluid is analyzed. By examining the amniotic fluid, you can promptly identify the existing danger and protect the child from negative consequences. This is a safe procedure; the collection is carried out under continuous ultrasound monitoring of the child’s condition. Of course, there is some risk, but it is minimal.

As medical practice shows, patients diagnosed with chlamydia often have and. It is for this reason that additional diagnostics are prescribed to determine cytomegalovirus, gonococci, herpes virus, syphilis, HIV and mycoplasma (including ureaplasma). Only this will give the doctor the opportunity to prescribe competent comprehensive treatment.

Treatment

Before proceeding directly to the treatment of chlamydia, it is important to identify pathologies of a non-infectious nature ( chronic diseases liver, kidneys, etc.). This is necessary because the course of therapy may include drugs that can significantly worsen the condition of a pregnant woman if she has problems with her work internal organs.

The patient must remain under the supervision of a specialist throughout the entire treatment period. When symptoms disappear, some patients stop taking medications on their own, which is a serious mistake - the remaining microbes become resistant to the drug used. This makes it much more difficult to completely cure the disease.

Also important factor The treatment is the state of pregnancy itself. Not all medications that help get rid of chlamydia are approved for use by pregnant women. For example, pregnant women are prohibited from taking tetracycline antibiotics due to possible side effects.

The most safe drugs antibiotics of the macrolide group are considered. However, even they can have side effects and jeopardize the health of the mother and child, so their use is allowed only as prescribed by the attending physician.

Chlamydia is treated in various ways:

1. Complex treatment, which includes receiving antibiotics, enzymes And immunomodulators.
2. Single dose of antibiotic, exhibiting high sensitivity to chlamydia.

Immunomodulatory drugs are not always prescribed for chlamydia. They are recommended for patients with immune system disorders that are detected through laboratory tests. Based on the immunological examination data, the attending physician may prescribe drugs that enhance immunity.

Enzymes play an important role in treatment:

• Firstly, their use allows the permeability of the membranes of diseased cells to return to normal.
• Secondly, enzymes reduce allergic sensitivity to drugs used for chlamydia.
• Thirdly, they have anti-edematous and analgesic effects.

In addition, enzymes enhance the effects of antibiotics, increasing their concentration in the blood by 20-40% and ensuring, at a lower dosage, the transfer of large doses to the affected internal organs and cells. It should also be noted that enzymes have a beneficial effect on peripheral circulation.

After completing the course of treatment, enzymes and vitamins are prescribed to stimulate regeneration.

Control of cure

After treatment of chlamydia in pregnant women, control tests are mandatory. For greater reliability and confirmation of the results, several types of studies are carried out.

2 weeks after completion of the course you can conduct sowing. This method should not be trusted 100%, since it can give a false negative result (show complete cure of the disease if chlamydia is present in the body).

Control methods of verification can be mutual fund (direct immunofluorescence) or PCR (polymerase chain reaction). Research can be carried out 3 weeks to a month after completion of the course of treatment. Sometimes these tests give a false positive result - they show the presence of chlamydia in the body when cured. This is because when these techniques are applied and an infection is detected, an appropriate signal is given, but it cannot be determined whether the pathogens are alive or dead.

Pregnancy after chlamydia

Chlamydia can cause serious harm to a woman's body. Most often, the infection disrupts the functioning of internal organs, but does not cause severe symptoms.

The question often arises whether pregnancy is possible after chlamydia. It should be noted that it is not always possible for a woman to become pregnant, since the infection can cause irreversible consequences leading to the inability to conceive a child. There is also a risk of ectopic pregnancy, when the fetus develops in the fallopian tube.

Pregnancy and chronic chlamydia are a rather complex combination, since the disease can lead to endometriosis– inflammatory processes of the external and internal uterine membranes. Endometriosis can make it impossible for the fetus to attach to the walls of the uterus, reducing the chance of pregnancy.

If a woman has fully recovered and has not experienced any complications, then there should be no difficulties with pregnancy.

Prevention

Any disease is easier to prevent than to treat later. Prevention of chlamydia is almost identical to the actions that should be taken to prevent other sexually transmitted infections.

Most The best way avoid getting chlamydia into the body - change sexual behavior. Should not be allowed sexual contacts With strangers. If you are not completely confident in a man, you must use a condom during sex. When using contraceptives, the risk of infection will be minimal.

One more preventative measure is to visit a specialist and undergo regular tests. This should be done at least several times annually if there are several sexual partners or if the woman is not sure about the health of her only partner. Timely diagnosis and appropriate treatment will provide reliable protection.

Both men and women should be tested for various sexually transmitted infections, including chlamydia, when planning pregnancy. If pathogenic microorganisms that provoke this disease are detected, it is necessary to undergo a course of treatment before conception. This approach to the health of the unborn child is the best measure to prevent sexually transmitted diseases.

In conclusion, it should be noted that chlamydia is a fairly common pathology during pregnancy. According to statistics, this disease is diagnosed in 10% of pregnant women.

Women who have previously had miscarriages, inflammatory processes of the appendages, and infertility are also susceptible to chlamydia. In this case, the probability of contracting this infection is about 65%. It is for this reason that any expectant mother should remember the risk posed by this pathology.

Pregnant women feel great joy when they find out they are pregnant. But at the same time, she begins to be overwhelmed with emotions. Everyone is afraid of health problems. After all, the mother’s immunity must be passed on to the child. By undergoing some examinations necessary during pregnancy, a woman may discover diseases that she had not previously even suspected of. Chlamydia is one such problem.

Chlamydia during pregnancy is dangerous, first of all, because it threatens the child. The likelihood of its infection in the womb or during birth is very high

Chlamydia is one of the most common diseases of the genitourinary system. The disease received this name due to the fact that the causative agent is specific microorganisms - chlamydia. These are intracellular microorganisms. They are motionless. But they can affect the respiratory tract, heart, organs of hearing and vision. When chlamydia enters the body, first of all, damage occurs to the mucous membranes of target organs. Next, they enter the epithelium, which promotes rapid damage to immune cells.

The difficulty in determining chlamydia is that under unfavorable conditions it does not manifest itself in any way. But it is precisely this problem that can cause spontaneous miscarriage and contribute to the formation of large scars in the fallopian tubes.

Main routes of infection

Chlamydia is transmitted primarily through sexual contact. The disease is more common in women. Therefore, in order to diagnose it in time, you need to visit a gynecologist once a year and take everything necessary tests.

Chlamydia most often enters a woman's body through direct sexual contact with an already infected partner. When the body begins to recognize pathogenic microorganisms, some inflammatory reactions develop. Sometimes they are so minor that they are simply ignored. Therefore, many people mistakenly believe that this disease passes without any obvious symptoms. But that's not true. Chlamydia can be sluggish, then the inflammatory process can even last several years.

In some cases, the cause of chlamydia infection can be ordinary household contact. People who frequently visit saunas and baths are especially susceptible to such infection. Although it has been proven that microorganisms cannot exist outside the human body, they can remain on household items for some time.

Symptoms of chlamydia

It is quite easy to recognize whether a pregnant woman is infected with chlamydia. Especially if the disease occurs in acute form. The woman’s body temperature rises, severe pain appears in the lower abdomen, and sudden bleeding is possible. The nature of vaginal discharge also changes. They become cloudy, have bad smell. Even yellowish vaginal discharge should cause concern. Another sign of the disease may be pain when urinating. Itching often appears in the perineal area. However, some other infectious diseases may also have such symptoms, so in this case You cannot self-medicate.

Diagnosis of the disease becomes more difficult if it is asymptomatic. To detect chlamydia in this case, a mandatory PCR test is performed.

Why chlamydia can appear during pregnancy

It is very bad that this malicious venereal disease may not manifest itself for a long time. Chlamydia can only be noticed in the acute phase, when an inflammatory process develops in the body. Pregnant women are much more susceptible to all kinds of infections than others. This is because their immune defense is greatly weakened. A pregnant woman who learns about such an unexpected diagnosis may immediately suspect her sexual partner. But the man is not always to blame. It should be remembered that the infection could have settled in the body for a long time, and manifest itself only under favorable conditions.

What threat does chlamydia pose during pregnancy?

The indolent form of the disease can quickly progress to the acute stage. This sometimes takes several weeks. Since microorganisms settle in cells, when they multiply in a woman’s body, they can severely damage target cells, and sometimes even destroy them completely. This is why pathogenic bacteria can become so active during pregnancy that they often cause miscarriages. In some cases, chlamydia penetrates the amniotic fluid, infecting the child. In this case, the baby is born with chlamydia.

Treatment of this disease During pregnancy, it should never be postponed. You can maintain your health and give birth to a healthy baby only with timely diagnosis of the disease. If chlamydia in a pregnant woman has been confirmed, treatment should begin immediately.

What may be the consequences of severe chlamydia?

The acute course of the disease can cause the following complications:

• pulpitis;
• endometritis;
• salpingitis;
• vulvo-vaginitis;
• thrush

Severe inflammation can lead to the formation of adhesions in the fallopian tubes or deformation of the tubes themselves. All this leads to ectopic pregnancies and even infertility.

What risks may there be for the child?

If there is an infection in the mother's body, the fetus does not receive enough nutrients. This often leads to vitamin deficiency, a lack of iron in the child’s body. The newborn has a low weight. Very often, infected women give birth prematurely. Therefore, if a woman knows that she has chlamydia, she should treat it before becoming pregnant. Only then will it be possible to carry a healthy baby to term without any problems.

The baby can catch the infection in late pregnancy. It is then that chlamydia is able to penetrate the cells of some internal organs of the fetus and severely infect them. In this case, the woman will definitely be admitted to a hospital to continue the pregnancy, since the life of the unborn child may be in great danger.

Infection can also occur as the baby passes through the birth canal. The nasopharynx, eyes and genitals of the baby are most often affected. This happens because the baby’s mucous membranes are in direct contact with the mother’s mucous membranes. Therefore, a woman should know that her baby may be born with multiple pathologies of internal organs.

Methods for diagnosing the disease

If a gynecologist suspects the presence of chlamydia in a pregnant woman’s body, he will have to refer her for some examinations:

1. Enzyme immunoassay blood test. It helps detect the presence in the body specific antibodies. Detected immunoglobulins A and M may indicate the development of an inflammatory process.
2. Smear from the urethra and cervix. It is painted with special dyes. Under a microscope, stained chlamydia are clearly visible.
3. It is necessary to undergo a PCR test. It helps detect chlamydia DNA. It is based on the results of this study that the main treatment is prescribed.
4. Isolation of the pathogen directly from target cells. But this method is practically not used due to its complexity and high cost.
5. The potential danger of infection to the fetus can be identified by collecting amniotic fluid.

All diagnostic methods must be used, not just one. Because the different methods may give different results. There may be several reasons for distorting the results. The most common of them is untimely examination of the taken material in the laboratory. Dead microorganisms can also become colored during the reaction. Therefore, it is not advisable to take tests immediately after treatment.

Principles of treatment of chlamydia during pregnancy

Treatment of the disease during pregnancy should be comprehensive. The sexual partner should also be treated together with the expectant mother so that the infection does not circulate in circles. Until complete recovery, it is better to avoid sexual intercourse or use condoms. If these rules are not followed, the disease may become chronic.

Treatment of chlamydia during pregnancy should not be delayed under any circumstances. As with any treatment bacterial infection, antibacterial drugs are used that penetrate into cells

Doctors set themselves the maximum task. They must cure the woman of her illness. At the same time, you need to ensure that the prescribed medications do not affect the baby’s health. There are a number of medications that will not cause much harm to the body of the unborn child.

But still, bad influence Medications on the child’s body cannot be ruled out. Therefore, courses of therapy should be short.

Self-medication of chlamydia, especially during pregnancy, is strictly prohibited. Treatment should be carried out by a doctor. Usually pregnant women are prescribed: Amoxicillin. Erythromycin and Viferon suppositories.

Is this treatment effective?

If you strictly follow all the doctor’s recommendations, you can get rid of the disease. But you should always check whether the prescribed therapy worked in each specific case. After all, not all chlamydia can be destroyed. A partner who has not completed the required course of treatment can re-infect the woman. Then treatment will need to be started again, and the consequences may be disastrous.

Preventive measures

Those women who have previously had gynecological problems are most susceptible to developing the disease in an acute form. Anyone can become infected with chlamydia. But healthy body activates its immune defense, which contributes to the rapid destruction of pathogenic microorganisms.

Chlamydia is an infection that is easier to avoid than to get rid of. The main rules for the prevention of chlamydia, as well as other sexually transmitted infections, is to have a regular sexual partner

Preventive measures usually include:

• compliance with personal hygiene rules;
• maintaining a correct lifestyle;
• sexual contacts should be regulated, with one partner.
• The main rule is to take care of your health. Visit a gynecologist once a year and take all necessary tests to help determine the presence of sexually transmitted infections.

The course of pregnancy after previous chlamydia

If the disease is detected in the early stages, then if all the doctor’s recommendations are followed, chlamydia can disappear from the pregnant woman’s body forever. In this case, the pregnancy will proceed without any complications. But if chlamydia occurs in acute stage, and the treatment was prescribed incorrectly, then in the future this can lead to complete infertility. Therefore, it is better to plan your pregnancy in advance. Then it will be possible to cure the disease before it occurs. After all, chlamydia is very dangerous for a pregnant woman and for the unborn baby.

In order to avoid complications and diagnose the disease on time, a woman should visit a gynecologist at least once a year. If we are talking about pregnancy, then you should visit the doctor at least once a month. In addition to the mandatory urine and stool tests, a woman must undergo all additional examinations prescribed by her doctor. Only after a complete examination will it be possible to talk about the state of health expectant mother.

If during the examination any disease is detected, including chlamydia, you should not immediately panic. We need to figure out why the infection might have occurred. A pregnant woman should understand that the problem cannot be ignored, since this can seriously harm not only her health, but also the unborn baby. Therefore, you must follow all the doctor’s recommendations regarding the prescribed treatment. After all, the sooner you can get rid of the disease, the sooner the woman will be able to fully enjoy her wonderful position.

Chlamydial infection is a disease belonging to the group of STIs, characterized by multifocal lesions involving the genital organs, and sometimes joints, the organ of vision and the respiratory tract in the inflammatory process.

SYNONYMS

Chlamydia; urogenital chlamydial infection.
ICD-10 CODE
· A55 Chlamydial lymphogranuloma (venereal).
· A56 Other chlamydial sexually transmitted diseases.
· A56.0 Chlamydial infections of the lower genitourinary system.
· A56.1+ Chlamydial infections of the pelvic organs and other genitourinary organs.
· A56.2 Chlamydial infection of the genitourinary system, unspecified.
· A56.3 Chlamydial infection of the anorectal area.
· A56.4 Chlamydial pharyngitis.
· A56.8 Chlamydial sexually transmitted infections, other localization.

EPIDEMIOLOGY

Chlamydial infection occupies one of the first places in the structure of all STIs.

According to the observations of European researchers, 80% of cases of acute inflammatory processes in the pelvic organs develop as a result of STIs, 60% are caused by Chlamydia trachomatis.

The prevalence of urogenital chlamydia varies widely among different age groups populations in different regions of the world, but everywhere this disease is recorded much more often than gonorrhea. Such a wide spread of the disease is facilitated by the existing changes in the sexual behavior of people observed in last decades: early entry into sex life, frequent changes of partners, the use of oral contraceptives, which reduce the fear of pregnancy, high mobility of the population and numerous contacts. Slow development clinical manifestations diseases, often the complete absence of pronounced symptoms leads to a delayed visit to the doctor or to an accidental diagnosis during examinations, especially during pregnancy. Asymptomatic infection occurs, depending on the location, with a frequency of up to 80%.

Consequences of genital chlamydia in the form of chronic inflammatory diseases uterine appendages, tubal infertility, ectopic pregnancy in women, as well as the adverse effect of chlamydial infection on the course and outcome of pregnancy for the mother and fetus - one of the main problems in the structure of urogenital and systemic diseases, all this affects the reproductive function of women. Since 1994, chlamydia in Russia has been classified as a group of diseases subject to mandatory statistical recording.

CLASSIFICATION OF CHLAMYDIOSIS

· Chlamydial infection of the lower genital tract.
· Chlamydial infection of the upper genital tract.

ETIOLOGY (CAUSES) OF CHLAMYDIOSIS

Damage to the genital tract is caused by the species Chlamydia trachomatis, belonging to the order Chlamydiales, family Chlamydiaceae, genus Chlamydia. The source of infection for urogenital chlamydia is a person with an acute or chronic form of the disease, with a manifest or asymptomatic course of the process.

The main routes of transmission of infection are sexual, household contact (rare), vertical (from mother to fetus during childbirth or antenatally). Due to the common routes of transmission of pathogens in STIs, chlamydia is often found in association with other microorganisms, such as gonococci, Trichomonas, mycoplasma, ureaplasma, etc.

PATHOGENESIS

Chlamydia has a pronounced tropism for the columnar epithelium lining the mucous membrane of the urethra, cervical canal, rectum, conjunctiva of the eyes and the nasopharynx. However, like gonococcus, chlamydia can affect the vulva in newborn girls, as well as the vaginal vault in women after hysterectomy.

Infection occurs with the elementary bodies of chlamydia. Reticular bodies do not have such properties.

Adhesion of elementary bodies on the host cell membrane and their penetration inside is the first stage of interaction between chlamydia and the cell. Penetrating into the cell, chlamydia turns off its most important protective mechanism, preventing the fusion of the lysosome with the phagocytic vacuole. Elementary bodies are introduced into the cell by pinocytosis (phagocytosis), protected from destruction by the phagosomal membrane. Several elementary bodies can be present in a cell at the same time, i.e. There may be several microcolonies of chlamydia in the cytoplasm of cells. Being in the endoplasmic vacuole (endosome), elementary bodies are successively transformed through the stage of intermediate bodies into reticular bodies, which, in turn, undergo binary fission.

Subsequently, upon completion of the period of growth and division, the reticular bodies undergo reverse transformation into elementary bodies. Newly formed elementary bodies leave the cell, destroying it, and infect new cells.

The complete intracellular development cycle when studied in vivo lasts 48–72 hours and depends on several factors, in particular the chlamydia strain, the nature of the host cells and environmental conditions. Outside the body, chlamydia loses its infectious properties after 24–36 hours at room temperature and is killed by ultraviolet radiation, boiling, and the action of disinfectants. At the same time, the possibility of maintaining the infectivity of contaminated material for up to two days at a temperature of 18–19 °C has been established.

The study of the immune response to this infection has shown that many complications are combined with severe disturbances of immunoregulation. The immune response to chlamydia is diverse and is characterized by the production of IgM, IgG, secreted IgA, inflammatory mediators - cytokines, such as interferon, IL-1, IL-4, IL-6, tumor necrosis factor and many others. In addition to hyperimmunoglobulinemia, polyclonal activation of B lymphocytes and the HRT response play an important role in the pathogenesis of chlamydial infection. In this case, chlamydia are absorbed by peripheral phagocytes. Monocytes settle in tissues for a long time, turning into tissue macrophages, and the chlamydia found in them becomes an antigenic stimulator. The type of development of the disease depends on the state of the person’s immunity, the severity of the infection, the pathogenicity and virulence of the infectious agent and many other reasons.

Complications of urogenital chlamydia are most often combined with severe immunoregulation disorders, in particular with a decrease in the number of T-lymphocytes, T-helper cells, and a deterioration in the patient’s interferon status. Recent studies have established that the presence of chlamydia is accompanied by a violation functional activity universal regulatory systems (immune, antioxidant, endogenous opiate, cyclic nucleotides, PGs, leukotrienes), which ultimately leads to chronicity of the process and many serious complications. Along with acute infection, a chronic process may develop.

Special attention of specialists in last years was devoted to the study of the persistence of chlamydia. In persistent forms, not only the morphology is changed, but also the expression of the main chlamydial Ags: a decrease in the synthesis of the main cellular components that impart special strength to the cell wall: lipopolysaccharides and MOMP (Mayor Outer Membrane Protein, a cell wall protein weighing 60 kDa) was found. Against this background, there is a continuous synthesis of heat shock protein with a molecular weight of 60 kDa. This protein plays a major role in the immunopathogenesis of persistent infection and the maintenance of a persistent inflammatory response. The presence of heat shock protein leads to: · antigenic overload of the body and the launch of a secondary humoral response with hyperproduction of IgG and IgA; · activation of a delayed-type hypersensitivity reaction, causing infiltration of mucous membranes by lymphocytes and monocytes; · triggering an autoimmune cross-response, since heat shock protein is similar to eukaryotic proteins; · the effect of “heat shock” in the host cell, stimulation of the development of a stress reaction in the microorganism with arrest of the cell cycle at the stage of reticular bodies.

Activated macrophages also produce TNF-a, which indirectly through IL-1 activates the proliferation of major connective tissue cells, promotes fibrin formation, and also increases the adhesive ability of lymphocytes to the vascular endothelium and reactivates macrophages.

Thus, the main mechanism preventing the redifferentiation of reticular bodies into elementary bodies is the action of a special spectrum of cytokines, leading to a deficiency of components and/or blockade of the synthesis of proteins of the outer membrane of the elementary bodies of chlamydia under the influence of factors contributing to the formation of persistent forms.

Pathogenesis of gestational complications

The consequences of chlamydia in pregnant women manifest themselves in the form of chronic inflammatory diseases of the genitourinary tract, cervix, pregnancy pathology with possible infection of the fetus.

Most often, an ascending infection develops from the lower parts of the genitourinary organs with infection of the OB and the development of chorioamnionitis. Aspiration or ingestion of infected agents leads to infection of the lungs and digestive tract of the fetus with the development of an infectious process even before the birth of the child. This can occur both with PROM and with intact membranes, for example, during the birth of a child through CS surgery.

Infection of the fetus with chlamydia occurs both in utero (antenatally) and through contact with an infected birth canal during childbirth (intranatally).

CLINICAL PICTURE (SYMPTOMS) OF CHLAMYDIOSIS IN PREGNANT WOMEN

From 5% to 13% of pregnant women in cities are infected with chlamydia; in 4–11%, genital chlamydia is asymptomatic. Since there are no clinical symptoms pathognomonic for genital chlamydia, including in pregnant women, its frequency must be assessed based on laboratory data from the detection of chlamydia in the cervical canal.

The progression of pregnancy in the presence of urogenital chlamydia without adequate treatment increases the number of perinatal complications and diseases of the newborn. The highest rates of preterm pregnancy were observed in those women whose blood serum contained IgM to chlamydial Ag, and C. trachomatis was found in the cervical canal of the uterus, which indicates a fresh active infection. The presence of IgG in the absence of IgM in the blood serum and the absence of C. trachomatis in the cervical canal of the cervix indicates an inactive form of infection and a certain degree of immunological protection of the body, and, accordingly, a lesser degree of influence on the fetus.

Possible complications of pregnancy:

· premature birth;
· spontaneous miscarriages;
· non-developing pregnancy.

The most common clinical form of genital chlamydia in pregnant women, as well as in non-pregnant women, is cervicitis, but in pregnant women this disease is more difficult to clinically diagnose. Special attention pregnant women suffer from acute urethral syndrome, often associated with chlamydial lesions of the cervix and urethra.

Endometritis occurs in the postpartum or post-abortion period. In an acute process, the temperature rises to 38–39 °C, pain in the lower abdomen, and copious mucopurulent discharge from the cervical canal appear. A chronic course of endometritis without pronounced clinical symptoms is also possible.

The frequency of infection of a newborn with a diagnosed infection in the mother reaches 40–70%. During childbirth, chlamydia is transmitted through direct contact of the fetus with an infected birth canal. In newborns and young children childhood Chlamydia most often affects the conjunctiva and nasopharyngeal mucosa. In this case, conjunctivitis, nasopharyngitis and pneumonia develop. In some cases, chlamydia causes gastroenteritis, proctitis, vulvitis in girls, and urethritis in boys.

DIAGNOSIS OF CHLAMYDIOSIS DURING PREGNANCY

Due to the fact that the clinical manifestations of chlamydia are not pathognomonic, asymptomatic forms of the disease are widespread, laboratory methods are of paramount importance in the diagnosis of these infections.

The following are subject to examination for chlamydial infection:
· women with mucopurulent discharge from the cervical canal, symptoms of adnexitis, infertility;
· persons who have had sexual contact with a patient with chlamydial infection;
· persons undergoing screening for other STIs;
· newborns from mothers who have had a chlamydial infection during pregnancy.

Factors and risk groups for developing the disease:
· prostitution;
· sexually active teenagers and women under 25 years of age;
· previous STIs;
· contact with a patient with chlamydial infection or with symptoms of urethritis/cervicitis.

PHYSICAL INVESTIGATION

When examined in the mirrors, signs of cervicitis can be detected. In some cases, there are no clinical manifestations of the disease.

It is recommended to examine the ducts of the paraurethral glands, and if there are symptoms of mild inflammation, pain or burning sensation when urinating, prescribe a test for chlamydia. As a rule, the urine of such women contains leukocytes and does not contain bacteria, so pyuria in pregnant women in the absence of bacteria in the urine is very suspicious in terms of chlamydia, described in the literature under the name acute urethral syndrome.

LABORATORY RESEARCH

The studied material in women is scrapings of the mucous membranes of the genitourinary organs (urethra, cervical canal of the cervix), in extragenital forms - scrapings from the rectum, conjunctiva, oropharynx.

The quality of the obtained clinical material depends on the physiological state of the patient at the time of collection.
sample. Clinical material can be the most informative if it is obtained under the following conditions:
· smears are taken in the presence of clinical signs of the disease;
· the patient has not used local therapy for at least the last 48–72 hours;
· the patient did not shower for 24 hours;
· the patient has not taken systemic antibacterial drugs over the past 3–4 weeks.

If it is not possible to adhere to the mentioned conditions, then it should be remembered that all of them can affect the quality of the study and distort its results.

Clinical material can be obtained using a Volkmann spoon, a special brush or a cotton/Dacron swab. In all cases, preference should be given to Dacron tampons.

When performing surgical interventions, it is possible to study surgical materials (endometrium, the fallopian tubes, adhesions, peritoneal fluid, etc.).

In newborns, discharge from the conjunctiva, nasopharynx, and vulva in girls and the first portion of urine in boys are usually examined. In case of death of children, sectional materials (trachea, lungs, liver, spleen, etc.) can be examined.

Diagnostic methods such as cell culture, PIF, PCR, ELISA are used to study materials obtained from the cervical canal, urethra, rectum, nasopharynx, conjunctiva, biopsy and surgical materials. To study the first portion of urine and vaginal discharge, only the PCR method is used.

Laboratory diagnostic methods include methods for determining the pathogen and its Ag, as well as methods for detecting a specific antibody response to C. trachomatis.

Pathogen detection methods
· PIF reaction using monoclonal antibodies labeled with fluorescein isothiocyanate.
· Molecular biological methods:
- DNA hybridization;
- real-time PCR;
- NASBA in real time, etc.
· Cultivation of the pathogen on cell culture (McCoy, HeLa-229, L-929, etc. lines). This method can be used to determine the sensitivity of chlamydia to antibiotics. PIF: the method is relatively simple and available to almost any laboratory. The sensitivity and specificity of the method depend on the quality of the luminescent antibodies used. Due to the possibility of obtaining false positive results, the PIF reaction cannot be used for forensic examination. In addition, this method is not recommended for studying materials obtained from the nasopharynx and rectum.

Nucleic acid amplification methods are highly specific and sensitive and can be used for screening, especially for the study of clinical materials obtained non-invasively (urine, ejaculate).

The specificity of the methods is 100%, sensitivity is 98%. These methods do not require preservation of the viability of the pathogen, but it is necessary to follow strict requirements for the conditions of transportation of clinical material, non-compliance with which can significantly affect the result of the analysis. These methods include PCR and real-time PCR. A new and promising method - NASBA (Nucleic Acid Sequence-based Amplification) in real time allows you to determine a viable pathogen and replace the cultivation method.

Cell culture is a priority method for laboratory diagnosis of chlamydial infection, especially for forensic examination; it is more specific than PIF and is indispensable in determining whether chlamydia is cured, since other methods can give distorted results. However, the sensitivity of the method remains low - within 40–60%.

A test to determine the sensitivity of chlamydia to antibiotics is not practical. Due to low sensitivity, ELISA is rarely used to detect chlamydia Ag. Methods for detecting a specific immune response are serological studies that can determine IgM, IgA, IgG to chlamydial Ags, which is especially important for diagnosing chlamydia in ascending infections (salpingitis, salpingoophoritis, pelvioperitonitis, perihepatitis).

Serological methods (microimmunofluorescence, immunoenzyme) have limited diagnostic value and cannot be used to diagnose urogenital chlamydial infection and, especially, to monitor cure. Detection of IgM can be used to diagnose pneumonia in newborns and children in the first three months of life. When examining women with PID, the detection of a 4-fold increase in IgG titer when examining paired blood sera is considered diagnostically significant. An increase in the concentration of IgG to chlamydia (to serovars D–K) is the basis for examining the patient to exclude lymphogranuloma venereum.

The diagnosis of cervicitis is established based on the detection of two criteria simultaneously: mucopurulent discharge from the cervical canal and the number of polymorphonuclear leukocytes in the material from the cervical canal, exceeding 10 in the microscope field of view at a magnification of 1000 times (when viewing at least five fields of view).

The diagnosis of urethritis in women is established based only on laboratory data: the presence in the material obtained from the urethra of more than 10 polymorphonuclear leukocytes in the field of view of a microscope at a magnification of 1000 times (when viewing at least five fields of view).

DIFFERENTIAL DIAGNOSTICS

Differentiate with similar diseases of non-chlamydial etiology (gonococcal, trichomonas, nonspecific infection).

EXAMPLE OF FORMULATION OF DIAGNOSIS

Chlamydial cervicitis.

TREATMENT OF CHLAMYDIOSIS IN PREGNANCY

TREATMENT GOALS

· Eradication of the pathogen.
· Disappearance of symptoms of the disease.
· Prevention of complications.

Since Chlamydia trachomatis is a pathogenic microorganism, and urogenital chlamydial infection is classified as an STI, the prescription of antibacterial drugs for treatment is mandatory. Antibacterial therapy is carried out regardless of whether clinical manifestations of the disease exist or not. Antibacterial therapy for urogenital chlamydial infection in the first trimester of pregnancy is undesirable. Treatment is prescribed after 12–16 weeks of gestation.

DRUG TREATMENT OF CHLAMYDIOSIS DURING PREGNANCY

If chlamydia is detected in pregnant and lactating women, one of the following drugs is prescribed:
Erythromycin 500 mg orally four times a day for 7–10 days;
Amoxicillin 500 mg orally every 8 hours for 7–10 days;
· josamycin orally 500 mg twice a day for 10 days.

Alternative schemes:
Azithromycin orally 1.0 g once;
· spiramycin orally, 3 million IU three times a day for 10 days.

Josamycin or amoxicillin is preferred over erythromycin as they have fewer side effects and are more effective.

Attention! Erythromycin estolate is contraindicated during pregnancy. It was previously thought that azithromycin, josamycin, and spiramycin should be prescribed cautiously to pregnant women, but there is evidence from many experts about the safety of these drugs during pregnancy.

For chlamydia in newborns and infants, treatment is carried out with the following drugs.
· In the first week of life:
- with body weight<2000 г - эритромицин 20 мг/кг в день внутрь в равных дозах не менее 14 дней;
- for body weight >2000 g - erythromycin 30 mg/kg per day orally in equal doses for at least 14 days.
· From 1 week to 1 month of life:
- erythromycin 40 mg/kg per day orally in equal doses for at least 14 days.

PREVENTION AND PREDICTION OF GESTATION COMPLICATIONS

Timely antibacterial treatment of chlamydial infection.

FOLLOW-UP

· Identifying sexual contacts is mandatory and important.
· Treatment of the sexual partner is mandatory.
· Registration: send an emergency notification to the KVD using form 089/ukv.

INDICATIONS FOR HOSPITALIZATION

If complications develop, treatment is carried out in specialized hospitals of dermatovenerological, obstetric-gynecological, and rheumatological profiles. The duration of inpatient treatment is determined by the nature of the clinical manifestations and the severity of the inflammatory process and ranges from 2 to 6 weeks.

ASSESSMENT OF TREATMENT EFFECTIVENESS

INFORMATION FOR THE PATIENT

· Patients should be warned that if they have a urogenital chlamydial infection, they can infect a sexual partner. Search and examination of sexual contacts is carried out depending on the clinical manifestations of the disease and the expected duration of infection (from 15 days to 6 months).

· Treatment of the patient and her sexual partner is a prerequisite for preventing the spread of infection. Patients should be informed that with inadequate treatment, complications may develop in the form of an ascending infection of the pelvic organs, and during pregnancy, premature termination of pregnancy, as well as infection of the fetus and newborn, is possible.

· If chlamydia is diagnosed in a pregnant woman, a woman in labor, or a woman in labor who has not received timely treatment, the newborn is examined and material is taken from the conjunctival sacs of both eyes. If a chlamydial infection is detected in a newborn, its parents are examined.

· Perinatally acquired C. trachomatis can persist in a child up to 3 years of age.

During pregnancy, any disease of an infectious nature can not only complicate the condition of the expectant mother, but also negatively affect the health of the child. One of these diseases is chlamydia. This pathology is extremely dangerous specifically for pregnant women due to its specific effect on the functioning of the entire reproductive system.

What is chlamydia

There are a huge number of sexually transmitted infections. One of them is chlamydia. This pathogenic agent has the biological properties of viruses and bacteria.

Once in the body, chlamydia is implanted into immune and epithelial cells. The pathogen can function in them for a fairly long period (about 4–6 years). A few days after the infection enters the body, the immune system begins to respond to the appearance of a foreign protein with increased production of leukocytes. This mechanism determines the development of the inflammatory process at the site of chlamydia localization. The severity of the manifestations of the disease largely depends on the activity of the immune system.

The most optimal environment for the life of chlamydia is the cells of the mucous layer of the genital and urinary tract. Rarely, this infection can affect the lower part of the large intestine. During pregnancy, when a woman develops chlamydia, the inflammatory process can affect the amniotic membranes and the fetus itself.

One of the features of chlamydia is that quite long time it can occur in a latent form, that is, without showing any clinical signs of infection. Therefore, there are often cases when a person, unaware of the presence of this disease, continues to spread the infection.

In most cases, chlamydia infection occurs as a result of unprotected sexual contact. However, the possibility of transmission of infection through contact and household contact cannot be ruled out. There is another route of infection, specific to pregnant women, which is called “vertical”. In this case, the pathogen migrates along an ascending path from the mother’s genital organs to the amniotic membranes. The infection then spreads to the amniotic fluid. The child periodically swallows a certain amount of water surrounding him. Thanks to this, chlamydia enters the fetus and affects the mucous membranes.

Is pregnancy possible with chlamydia? Of course, this option is not excluded. However, this can be extremely dangerous for the unborn child. Experts in the field of women's reproductive health strongly recommend that women with this disease refrain from conceiving until they have fully recovered. If the pregnancy occurred unplanned, then therapy will be carried out according to the characteristics of the disease and the extent of the pathological process.

Symptoms

Chlamydia can be asymptomatic for a very long time. However, this applies to a greater extent healthy women. During pregnancy, a woman’s immune system is depressed, so the first signs of the disease may appear 1–2 weeks after infection.

The main symptoms of chlamydia during pregnancy:

• unusual discharge from the genital tract;
• general signs of intoxication (malaise, fever, headache, etc.);
• drowsiness, sharp decrease in performance;
• aching pain in the lower abdomen, which can worsen when exposed to high temperatures(in a bathhouse, sauna, hot tub, etc.);
• frequent false urge to urinate;
• emptying Bladder accompanied by pain, itching and burning.

In clinical practice, there are cases of Reiter's syndrome in pregnant women, a special form of chlamydia. This disease is caused by the presence of a characteristic symptomatic triad:

• inflammation of the urethra;
• inflammation of the mucous membrane of the eye (conjunctivitis);
• inflammation of the joints (mono- or polyarthritis).

In some cases clinical picture chlamydia during pregnancy can be vague, that is, in the initial stages of the disease, a woman may not feel any obvious symptoms. In addition, the expectant mother may associate the appearance of certain pathological signs with pregnancy and, because of this, do not immediately seek help from a doctor.

When planning a pregnancy, a woman should be tested in advance for infections of the reproductive system in order to avoid the occurrence of various complications in the future. It is also equally important for the potential father to undergo similar examinations.

If pregnancy does not occur for a long time with regular sexual intercourse, then this is a reason to be tested for chlamydia. Also characteristic features There may be frequent cases of spontaneous abortion in the early stages or the detection of other sexually transmitted infections.

Causes

Chlamydia during pregnancy develops under the influence of the following provoking factors:

• increased susceptibility of women to the effects of pathogenic agents;
• contact of a pathogenic pathogen with the mucous membrane of the genital organs during unprotected sexual intercourse;
• neglect of personal hygiene rules;
• hypothermia or overheating of the pregnant woman's body;
• long course of antibiotic therapy;
• the presence of other sexually transmitted infections.

Kinds

According to the clinical course of the disease, the following forms of chlamydia are distinguished:

1. Acute (severe symptoms, active progression of the infectious process, incubation period - no more than 2 months);
2. Chronic (incubation period is longer than 2 months; the clinical picture is a sluggish inflammatory process with vague symptoms). In turn, this form of chlamydia has two subtypes:

• recurrent (phases of remission alternate with exacerbations of the disease);
• asymptomatic (the course of the disease has minor external manifestations).

1. Reinfection (re-infection after complete recovery).

Based on the localization of the pathological process, several types of chlamydia are distinguished:

• urogenital (the genitourinary system is affected);
• respiratory (the infectious process invades the respiratory tract);
• ophthalmochlamydia (chlamydia are localized in the structures of the visual apparatus);
• inguinal lymphogranulomatosis (the organs of the reproductive system, as well as regional lymph nodes, are involved in the pathological process);
• minor collagenoses (chlamydia affects connective tissue);
• congenital (chlamydia can affect any organ or system of a child infected in the womb);
• generalized (caused by infection in the circulatory or lymphatic system).

A distinctive feature of chlamydia is the non-specificity of strains. The same type of this infectious pathogen can cause the development of both respiratory and urogenital chlamydia.

Diagnostics

Statistics show that the vast majority of pregnant women learn about chlamydia after registering with antenatal clinic. This makes further therapy much more difficult. Gynecologists recommend that women of childbearing age be periodically tested for sexually transmitted infections, especially if there is no absolute confidence in the health of their sexual partner.

Diagnosis of chlamydia during pregnancy includes the following measures:

• blood analysis;
• Analysis of urine;
• scraping from the mucous membrane of the vagina and urethra.

Additionally, to confirm the diagnosis, the PIF test - direct immunofluorescence - can be used. Its essence lies in identifying specific antibodies. This examination can give a general picture of the disease, but does not provide the opportunity to determine the exact strain of the pathogen that provoked the disease.

Also, if chlamydia is suspected in a pregnant woman, the PRC diagnostic method can be used. This examination allows not only to identify the infectious disease itself, but also to determine the degree of its development long before the first symptoms appear. In clinical practice, this method is used extremely rarely to establish this diagnosis, since it is characterized by high cost.

The most informative way to detect chlamydia in a pregnant woman is the cultural method, based on cultivating bacteria in special nutrient media to accurately determine their type. In this case, the choice of drug for treating the disease is based on the results of its action on a specific strain.

The molecular method is also highly informative, but it is carried out in clinics with good technical support and a highly qualified medical staff. Its essence is to analyze the nucleic acids of DNA molecules.

If the attending physician detects signs of chlamydial infection in the pregnant woman, a test is prescribed to collect amniotic fluid. This manipulation is carried out under ultrasound control.

Treatment

The basis of complex treatment of chlamydia in a pregnant woman, as in the case of other infectious diseases, is antibiotic therapy. Undoubtedly, such substances can harm the fetus. Therefore, if the clinical course of the disease is not acute, then the attending physician may limit himself to prescribing general restorative drugs. The World Health Organization recommends following this treatment strategy for chlamydial infection in pregnant women.

If, nevertheless, the expectant mother has severe symptoms of chlamydia and an acute inflammatory process develops in the body, then she is prescribed local antibacterial agents that are not able to penetrate the placental barrier. The course of treatment with such drugs is determined individually by the attending physician.

If the therapeutic effect from the use of this group of drugs is lower than expected, then patients are prescribed oral antibiotics of the macrolide group and the latest generation of floxocin. Taking these drugs can be a one-time use, provided that the effectiveness of a particular drug against a specific strain of the causative agent of chlamydia has been confirmed by the results laboratory research. In addition to antibiotics, comprehensive treatment of chlamydia during pregnancy will include immunomodulators, vitamins and probiotics.

Independent selection of antibacterial drugs for a pregnant woman can negatively affect both her health and the normal intrauterine functioning of the fetus. In case of chlamydia infection during pregnancy, incorrect dosage selection or untreated infection can have the most dire consequences for the fetus. Therefore, all aspects of chlamydia treatment must be approved by a gynecologist.

Separately, it is worth mentioning the control of the cure of chlamydial infection. This procedure is mandatory and is carried out no earlier than two weeks after the end of the course of therapy.

Treatment of chlamydia should be carried out not only in relation to the woman, but also to her sexual partner. If this is not done, then the risk of re-infection is high and all previously carried out therapy becomes meaningless.

Fact. Well-known pediatrician Evgeny Komarovsky has repeatedly said that he is wary of treating chlamydia during pregnancy with antibacterial drugs. He believes that in most cases it can cause harm disproportionately greater than the chlamydial infection itself. However, Komarovsky warns that each case is individual and requires a balanced approach.

Treatment at home

Traditional medicine as a supplement to drug treatment chlamydia can be quite effective. Pregnant women with this diagnosis are advised to take orally decoctions prepared using boron uterus or dill seeds. They have a proven antibacterial effect and do not have a negative effect on the fetus. They can also be used topically for hygienic treatment of the genitals.

In addition, it will be useful for the expectant mother to include onions and garlic in her diet. Due to the content of phytoncides, they are highly active in the fight against infectious pathogens. Also, these products can have a general strengthening effect on the immune system, which during pregnancy needs additional support.

Prevention

The most effective prevention chlamydia is the use of barrier contraception and the presence of a regular sexual partner. Regular gynecological examinations with taking smears for the presence of this infection.

If a woman plans to become a mother soon, then she and the potential father of the unborn child should undergo a comprehensive examination.

Complications

Chlamydia can cause the development of many pathological processes in both the body of the mother and her child. They can significantly complicate the course of labor and also negatively affect the health of the baby.

In a pregnant woman, chlamydia can cause complications such as:

• cervical erosion;
• endometritis;
• urethritis;
• spontaneous termination of pregnancy;
• premature birth;
• excessive volume amniotic fluid;
• weakening of contractions and slow opening of the cervix;
• cervicitis.

For a child, chlamydia during pregnancy can have the following consequences:

1. Infection of the respiratory, visual and reproductive systems, which leads to disruption of their intrauterine formation.
2. Hypoxia (oxygen deficiency), which can negatively affect his physical and neuropsychiatric development.
3. Infection during passage through the birth canal.

The immune system of a newborn is very vulnerable to the effects of a variety of pathogenic agents. Therefore, if the mother is infected with chlamydial infection, then there is a high probability that the child will also become infected during childbirth. In newborn children, chlamydia is incomparably more severe than in adults. A fatal outcome cannot be ruled out.

Bottom line

Chlamydia is a common infection of the female genital area. It can cause many different diseases of the reproductive and other body systems. This is especially true for pregnant women. The development of the infectious process significantly complicates the course of pregnancy and childbirth, and also has an extremely negative effect on the baby’s health. However, experts have developed several treatment regimens for chlamydia, which in practice can ensure complete recovery with minimal damage to the fetus.

The key to successful treatment of chlamydia during pregnancy is timely diagnosis and strict implementation of all medical recommendations.

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 possess 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 a pregnant woman “shares” her protection with the baby’s body and works somewhat differently than usual. Therefore, chlamydial pathogens feel free in the body of the expectant mother 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 most comfortable in the tissues of the woman’s genital organs; 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. The 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 rupture of amniotic fluid and weak labor, which threaten 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 for the little person. 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 child. 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 for 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 common to other infectious diseases of the genitourinary system and require different therapy.