Today there are many different diseases that are diagnosed and treated actively, using a variety of drugs local and systemic plan, including during pregnancy.
And regarding some kinds of infections from scientists and physicians there are disputes, the threat these agents during pregnancy, whether their active detection and treatment.
The special attention last decade give Ureaplasma and Mycoplasma, the specific species of pathogens that appear in the genital area of men and women. It is relative to the data of microbes do mothers raises the most questions – is it necessary to treat these infections, if no symptoms and did not care? Let’s talk more about these specific diseases.
Do I need to treat Mycoplasma and Ureaplasma?
Today, there are certain “fashion” on the diagnoses and the corresponding treatment of certain pathologies, including in gynecology. The disruption of the microbial biocenosis, dysbacteriosis, as well as Mycoplasma and Ureaplasma is one of the leading positions in this list. But today in the study of literature from foreign sources there’s no indication that expectant mothers must examine, identifying Mycoplasma and Ureaplasma, and especially no reason to treat these pathologies.
Moreover, international sources have identified these pathogens among the normal microbial flora of the genital tract of men and women, in rare cases, the opportunistic group. But in our country there is a perverse Hyper-diagnostics of many diseases and infections, including the treatment of Ureaplasma and Mycoplasma in nonpregnant and pregnant women, including with antibiotics. This leads to excessive drug load on the body, and during pregnancy pose a risk for the fetus, because the drugs are not harmless for it at any time.
The ureaplasmosis at pregnancy
Today quite a large number of women attending private clinics and ordinary clinics, wasting your health, time and money for treatment of the non-existent diagnosis as “ureaplasmosis”.
But in reality, according to the world researches and classification ICD-10 diseases simply does not exist. There is not a single mention of it in the international guidelines and scientific journals produced in the world, about Ureaplasma in the medical environment know their properties well and have long been studied and not found evidence of their pathogenicity.
To date, the international community of infectious disease specialists, obstetricians and gynecologists Ureaplasma is related to the normal component of the microbial flora of the genital tract of men and women.
They do not harm health and do not require any kind of special attention. The vagina of healthy women, including during pregnancy, contains many millions of bacteria belonging to different species and groups of strains. Ureaplasma is one of the variants of the microbial inhabitants. They identify more than half of perfectly healthy in all respects women.
Therefore, Ureaplasma does not apply to pathogens that are transmitted sexually, they are elderly and not sexually active women, virgins, and girls. The presence of these pathogens does not imply any pathology and does not require any action.
Of pathology: is it possible?
Like many other microbes of the usual microflora of the vagina, sometimes Ureaplasma, and often mixed with other pathogens can lead to the formation of the inflammatory process. And the leading role of the ureaplasmas in this is not exactly proven. As a result, on a background of sharply depressed immunity, the disruption of the microbial balance due to gross and serious interference leads to inflammatory lesions of the urinary system.
Often there are lesions of the urethra, and often this affects men as well as bladder and tissues of the kidneys. That is, Ureaplasma manifest themselves in this situation as any other microbial flora, not caught in their habitat. In the region of the female genitalia, including pregnant women, she any manifestations and does not generate danger to the gestation is not.
The effects of Ureaplasma during pregnancy for mother
Based on the above, it is possible to make a clear and unequivocal conclusion – the Ureaplasma does not generate infertility and miscarriages, and she is not threatened intrauterine infections and premature birth. This has been proven numerous ongoing world-wide research. They do not affect conception, in the further course and any adverse pregnancy outcomes. But their presence in the smear just to explain the arisen complications, not to dig and find out the true causes of the incident.
The effects of Ureaplasma to the fetus (child)
Ureaplasma do not penetrate to the fetus during pregnancy will not affect his growth and development can not cause any harm the baby while passing through the birth canal, even if fall on the skin or mucous membranes. These microbes do not form malformations, anomalies and diseases, which they often credited.
The analysis on Ureaplasma in pregnant women: normal and decoding
In international practice, studies that detect Ureaplasma, is not carried out, they are not written into the guidelines and unfounded. But, without any evidence-based research, Ureaplasma included in some of the recent recommendations by dermatology and cosmetology. They say that the ureaplasmosis should be treated in the presence of concentrations of the pathogen in the volume of more than 104 CFU/ml. However, immediately made the reservation that only when there is evidence of inflammation on mucous membranes. In gynecology and obstetrics such recommendations and any guidance on diagnostic protocols is not at all!
But this figure is also taken empirically no proven data that fewer microbes safely – and more leads to pathologies. This allows you to treat perfectly healthy patients from a non-existent illness for a long time and enough money, after all bring this organism is almost impossible find it at very many.
For the detection of Ureaplasma is a swab from the vagina and cervix, and the contents analyzed by PCR or conduct the inoculation (microbiological culture study microbes under the microscope). Note that the titer of antibodies to pathogens that do not determine, because he did not cause any response of the immune system, which once again proves that it is not an infectious agent. In the analysis of Ureaplasma valid, it is a normal variant and needs no treat the concentration of the pathogen.
Treatment of Ureaplasma in pregnancy
According to the world researches and guides the examination and treatment of a Ureaplasma is not shown to anyone, especially pregnant women. If there is evidence of urethritis, cystitis or other health problem, is to exclude the more real and obvious reasons for this. Therefore, the prescription of antibiotics during gestation, immunostimulators, and even the local drugs suppositories, vitamins and other procedures is not justified. Although there is evidence of domestic manuals that the treatment is required in excess of the level of ureaplasmas more than 104 CFU/ml, usually they do not lead to inflammation of the vagina, cervix or urethra, there are additional pathogens.
Mycoplasmosis in pregnant women
Today the incidence of mycoplasmas in the genital area is quite common in our country diagnosis. Often put it when you visit a gynecologist outside of pregnancy or in the period of planning, and then long from porn are treated, and often to no avail, Mycoplasma again and again detected in smears on flora.
As such, the General diagnosis of “Mycoplasma” in the domestic and international guides are not included, there are special types of pathogens causing respiratory tract infections in children and adults, and a separate type of genital infection. But not all Mycoplasma dangerous in terms of destruction of the reproductive sphere. Therefore, during pregnancy a mycoplasmosis is not always dangerous and does not require any curative action. Always it is necessary to understand what is revealed, and does the detection of mycoplasmas in clinical manifestations.
The types of mycoplasmas: the relationship of infection
The body may contain several types of Mycoplasma, but for urogenital topical only two species of the pathogen, the properties of which the degree of danger vary significantly.
It’s these types of as:
- Mycoplasma genitalium (genital type of the pathogen);
- Mycoplasma hominis (belonging to the group of conditionally pathogenic flora).
The properties of these two types of pathogens vary considerably, due to their microbiological characteristics.
Genital Mycoplasma (M. Genitalium) belongs to the group of sexually transmitted infections, and its discovery in a woman is the real reason for the full treatment. Even identifying it with one of the partners (men) requires treatment both to have formed a serious danger during pregnancy and childbirth. The prevalence rate of Mycoplasma in our country does not exceed 5%, but if there is inflammation of the urethra or cervix analysis for this type of Mycoplasma is required (both the pregnant woman and her partner).
Mycoplasma hominis refers to the number of conditionally pathogenic microorganisms that are allowed in the composition of vaginal secretions from healthy women, including during pregnancy. They don’t make their presence any complications. Only in certain cases, when a weakened immune system and sharply expressed violations of the microbial flora of the vagina (in the presence of bacterial vaginosis) this type of Mycoplasma can be a member of the inflammatory process. In these cases there may be complaints of pain in the abdomen and discharge, but usually it is the microbial Association of opportunistic pathogens. Under normal conditions, without any complaints such discovery even when pregnancy does not require treatment. It is widely distributed, from pregnant women to 50% of cases.
Approaches to Mycoplasma in pregnant women in domestic and foreign practice
Often doctors do not detect the difference between the two types of Mycoplasma, given that the overwhelming percentage of cases detected Mycoplasma hominis that is, treatment that does not bring effect. Naturally, this type of Mycoplasma, treating normal microbial flora of the vagina, treated poorly, reducing the concentration of the microbe, and its presence remains. This leads to the vicious practice of forming a “persistent and poorly treated” infections, which in fact are not a disease.
In foreign literature there are no diagnosis of mycoplasmosis regarding the genitals, if planted Mycoplasma hominis, and even if you have bacterial vaginosis, the recommendations of the who treat it, and not the Mycoplasma. Her tests conduct during pregnancy is not necessary.
Analysis of Mycoplasma in pregnant women: normal and decoding
If we talk about the detection of Mycoplasma genitalium (infection, resulting in serious problems), it is important to have a swab from the vagina and cervix, exploring it by PCR. All other tests don’t have a high range of reliability and accurate result will not give. Diagnosis based on smear microscopy, blood tests for antibodies or crops impossible. So let’s talk more about the nuances of the diagnostic process.
The tests for Mycoplasma are almost always detected M. hominis, but rarely detect M. genitalium, which is needed in the diagnosis. Therefore, this method is not applicable in the diagnosis in pregnant women. Conducting planting, the definition of sensitivity to antibiotics and the level of M. hominis has no special meaning, so as to treat it is not required. The presence in smears of M. hominis does not talk about infection, but only about the carrier of this pathogen, even if its level exceeds 10*4 CFU/ml, but any signs vaginosis and inflammation.
PCR for Mycoplasma the most sensitive method, it allows to detect M. genitalium in 99% of cases, which is important for treatment. For the analysis carried out the blood collection from vein, and also takes a scraping from a mucous urethra or the vagina. Prior to the collection of strokes it is important not to urinate for 2 hours. If the result is negative, it means that M. genitalium body there. If a positive result is necessary to making decisions about treatment.
Determination of antibody titers by ELISA in the diagnosis of mycoplasmosis is not applicable, the results are often dubious or false negative, that does not give accuracy.
In the presence of inflammation and detection of M. hominis is carried out to determine the more likely causes of inflammation – the detection of chlamydia, gonorrhoea, as well as a number of sexually transmitted infections, urinalysis and blood.
The consequences of Mycoplasma during pregnancy for mother
Depending on the Mycoplasma species will vary considerably, and the prognosis for the pregnancy. The presence of M. hominis in no way affect the conception, pregnancy and childbirth, does not lead to intrauterine infection, damage of the placenta or membranes, not in danger of miscarriages and premature birth. The presence of the pathogen does not require any therapeutic interventions during gestation. The presence of M. genitalium causes inflammation and adhesions in the genital area, which threatens to infertility, miscarriages and pregnancy losses, the risk of PPH.
The effects of Mycoplasma to the fetus (child)
The presence of the future mother M. hominis does not have an effect on the development of a fetus. It is not dangerous in any period of pregnancy, does not lead to infection in childbirth and has no effect on the growth and development of the fetus.
Quite another thing if it is M. genitalium: it does not penetrate to the fetus, but may cause damage to the placenta and fetal membranes, which threatens the birth of a premature or underweight baby. Also for this type of infection is dangerous the presence of congenital mycoplasmosis is an infection of the child leading to liver, lung tissue, the formation of prolonged jaundice and possible meningitis. It requires immediate treatment.
Treatment of Mycoplasma in pregnancy
Treatment is required only in the presence of M. genitalium, which can harm the pregnancy and the fetus. Of drugs applicable Vilprofen or Azithromycin, dosage and course of treatment the doctor selects individually on the basis of pregnancy and the health of the mother. On average, the rate of medication leaves 5 to 7 days, in some cases problemas to two weeks. Thereafter, the control analyses to confirm the elimination of the pathogen from the tissues.
