29.03.2024

Chlamydia in pregnancy: risks to mother and fetus, treatment

During pregnancy infections in the body, including those that are transmitted by intimate contact is highly undesirable and often very dangerous.

This is true for viruses, bacteria, and special intracellular parasites – chlamydia.

They form a specific infectious pathology of chlamydia, which often has no distinct symptoms, but during pregnancy can significantly harm the health of both the mother and the developing fetus. What are the features of a pathology than a nasty chlamydia, and how it needs to be treated?

Characteristics of the pathogen: specific properties

Chlamydia belong to the group of sensitive infections that are transmitted by intimate contact. The causative agent belongs to a particular form of life, it’s not exactly a bacterium, but not the viral particle along with the intracellular Mycoplasma they live and affect the cells of the body, possessing certain properties of microbial organisms and viral particles.

Parasites can’t, is similar to viruses that exist outside the cellular structures of the human body that is because they cannot produce energy for life and get it out of the mitochondria of the affected epithelium. The size of chlamydia are different from microbes and viruses, and for them there are specific techniques of identification and subsequent treatment.

Where is evolving infection: stages of infection

The most comfortable place to dwell chlamydia is the epithelium of the urogenital system of women, therefore this area is most often affected through sexual contact and infection through sexual intercourse. There are cases and respiratory chlamydia, and the lesions of the lower small intestine, where there is a specific epithelium. But such cases are uncommon, especially during pregnancy. In the period of pregnancy in young women may lose not only the urinary tract and the genital tract, but also the fetal membranes, tissues of the reproductive organs and the child.

The source of infection for women will be the carrier of chlamydia, usually a sexual partner. It is important to know that men pathology can exist for a long time and be asymptomatic, and frequently the fathers unaware of their infection and risk for a pregnant woman.

The highest percentage of infection have unprotected intimate contact. There is evidence that chlamydia can be transmitted by casual contact, but such probability is low, on average, such a path is not more than 5% of all cases. It’s swimming in the same tank with the sick, the use of common towels, hygiene products.

One of the important ways of transmission is the vertical contamination is the transfer of the pathogen from a sick mother to fetus. During gestation, the agent is able to infect the fetal membranes, enter the amniotic fluid and affect the baby. Partially chlamydia fall within its body by swallowing a tiny infected amniotic fluid. Also chlamydia can be fixed on mucous crumbs and hit them.

Comes pregnancy for chlamydia?

Often women who have suffered chlamydia before, or if it is detected in the survey are worried whether the infection to infertility or problems with conception. Infection it’s possible the pregnancy if the ovaries are working full formed ovulation, but it is worth remembering that the pathology may threaten the development of the embryo. So in a period of detection of disease should delay the planning and conception at least to the period when the infection propechetsya and control tests will not be detected. Chlamydia is fairly well treated, when it is used affordable drugs.

During the planning of pregnancy, each couple should undergo a full examination that will allow you to identify such disease, and will save in the future worries and unnecessary risks.

But if the pregnancy was not planned, and is formed on the background of existing of chlamydia, one should not be worry. Today there are ways and methods of treatment of diseases in pregnant women who do not cause problems in the fetus and negative effects to it.

Of infection, variants of course

Infection occurs through close contact of mucous membranes with an agent, if chlamydia into the surface of the mucous membranes in the genital area and the vagina, cervix. After a short period of time, the pathogen penetrates the epithelial cells and causes irritation and arousal of immune cells, macrophages due to the absorption of part of chlamydia during phagocytosis. Inside the human body the weakening of immune protection or high infectious dose of chlamydia can be up to three years or more. However, the body does not remain indifferent to the formation of infection. After a few days from the moment of infection the immune response is formed of a body that forms an acute inflammatory response and development of disease symptoms. It is important to know that chlamydia infection can occur in two forms, differing in their manifestations and severity:

  • Sharp, and bright with pronounced inflammatory symptoms
  • Chronic, blurry and indistinct symptoms, chronic progressive destruction of epithelial cells.

Depending on this period of infection, pregnancy, will vary the feature manifestations of chlamydia and the risk of infection to the fetus and the mother.

Specific symptoms of chlamydia during pregnancy

This infection is typically asymptomatic, and dangerous disease, especially during the planning and childbearing.

About 70% of women unaware of their disease, and becomes a source of infection for the partner. The remaining approximately 30% of pathology can manifest itself in certain symptoms, but symptoms not expressed and not clearly.

Of the characteristic symptoms include the discharge, having a mucous or Muco-purulent character. Selection often differ in color – they are yellowish or greenish, have an unpleasant odor.

Also possible complaints of poorly pronounced tenderness in the region of the pelvis and external genitals, burning sensation or itching, heaviness or discomfort in the projection of the bladder.

Is pregnancy possible pain and discomfort before menstruation and intermenstrual spotting. It is possible to have weakness and slight fever.

Similar symptoms do not have high specificity as to exactly chlamydia during pregnancy, they can be any other urinary tract infections. Strictly specific manifestation that is typical for this infection is not, therefore, a key role in the diagnosis belongs to the doctor and laboratory confirmation of the diagnosis.

The appearance of any symptoms that are suspicious in terms of infection of genitalia and urogenital system, especially during pregnancy, should be cause for seeking medical attention and active treatment.

How dangerous chlamydia during pregnancy

In pregnant women infection can have long prodati in a latent form, and not have any serious consequences for the health of the mother. But also a reactivation of pathogens, when they are late detection and lack of adequate treatment chlamydia threatens the formation of serious complications from the mother’s body.

This should reckon:

  • Inflammatory lesions of the genital organs and pelvis. Chlamydia can infect the vagina, uterus with appendages, which threatens the sluggish development of salpingitis, endometritis, or salpingo.
  • the formation of the disease Reiter, which detects typical symptoms with a lesion of the urethra and the formation of urethritis, inflammatory processes of the mucous membranes of the eye – conjunctivitis, and arthritis education.
  • stricture formation in the urethra, leading to a sharp narrowing of its lumen and difficulty urinating.
Consequences of chlamydia for baby

Women often worry about losing chlamydial infection of the fetus and newborn child. The consequences of infection are highly dependent on gestational age and degree of activity of the infection. If this is the early stages of the first trimester, the infection is most dangerous and can face serious consequences in the form of intrauterine death of the embryo, rough multiple malformations and fading of pregnancy. Gross defects usually cause the embryo ceases to develop and the rejection of its and fetal membranes bleeding.

At a later date possible violation of fetal development because of the formation of placental insufficiency. The defeat of the placenta infectious agent disrupts the flow of blood and oxygen to the fetus, which lead to chronic hypoxia and nutritional deficits. Long-term effects of hypoxia leads to functional and organic lesions of the tissues of the body and especially the brain.

If to speak about the impact of chlamydia on the child in later life and at birth, probably the presence of certain symptoms. These include the birth of the crumbs from the hypertonicity of muscles, disorders of the nervous system and the severe consequences of hypoxia in brain tissue cysts, foci of hemorrhages. Due to prolonged effect of hypoxia in utero baby is born with a small body mass and signs gelatteria, IMR.

Infection with chlamydia in the later stages of gestation threatens the child in utero infection. Often when you lose a baby is suffering kidney and liver, the pancreas, which often significantly affects the overall condition. The development of congenital chlamydia manifests itself by the presence of typical symptoms:

  • specific lesions of the eye – ophthalmoplegias. For them typically the development of conjunctivitis with anomalous inclusions in mucous membranes.
  • formation of congenital pneumonia chlamydial origin
  • brain lesions with the formation of seizures.

Also for congenital chlamydia cases, the existence of the syndrome of Fitz-Curtis, is the presence of hepatitis C manifestations of ascites accumulation in the peritoneal cavity fluid and the development of peritonitis.

Analysis for chlamydia in pregnant women: normal and decoding

Chlamydial infection did not appear today, it existed many centuries ago, but to reveal it could not, therefore, cases of miscarriage and of malformations associated with other factors. Today, modern medical lab can identify the pathogen and to determine the degree of activity, the risk to the fetus and the mother. Today, the use of immunological and serological diagnosis methods of detection and identification of the pathogen on the results of PCR-diagnostics.

Normally, when the PCR study, the result for chlamydia should be negative. Positive results indicate detection of the pathogen in the cells of the body. For research are sampling the materials – it can be vaginal secretions, buccal mucus or the contents of the urethra, according to the strokes determine the causative agent. Detection of the titer of antibodies speaks about the activity of the infection and the presence of the pathogen.

In some cases, is the definition of intrauterine infection of the fetus. With this purpose, take samples of amniotic fluid under ultrasound control and monitoring of mother and fetus. After obtaining a sample, it is also subjected to study, which gives a notion about the status of the child and the possible influences on him.

In addition to the chlamydia, if you suspect genital infection, diagnose all other likely pathogens – viruses, bacteria and mycoplasmas. This is necessary for planning the subsequent treatment and identify the risk of complications. The woman carried out a full comprehensive examination of all organs and systems, as well as ultrasound of the fetus and genitalia, to determine what effect the infection has on the child and the principal internal organs of the female. In addition, it is necessary in order to determine which drugs are permissible to the reception on the gestation and how they can affect the baby.

Treatment of chlamydia in pregnancy: what methods and drugs applicable

Therapy of chlamydia is carried out strictly under the supervision of a physician, is prohibited with the disappearance of signs of infection independently to complete the treatment without going through the full course. This leads to the chronicity of chlamydia and its transition into the chronic form. In addition, due to such reckless actions is formed resistance to drugs acting on chlamydia, which complicates further treatment.

Although drugs selects only the doctor, a woman should know the main groups of drugs used in the suppression of the activity of chlamydia.

In the period of pregnancy not all medications, as they can have dangerous side effects – teratogenic and embryotoxic, threatening to fetal health problems. So, tetracycline antibiotics used in the treatment of chlamydia in pregnant women is prohibited due to their negative effect on teeth, bones, and kidneys of the fetus.

Relatively safe today in the treatment of chlamydia is recognized as the antibiotics of the macrolide group. But this does not mean that they should be applied independently and without the supervision of a physician. Only the expert chooses the optimal dosage and treatment course, monitoring the condition of mother and fetus during treatment.

Options therapeutic regimens for chlamydia:

  • A single loading dose of the drug, which is sensitive chlamydia
  • a complex regimen of medications, which is longer, but the doses matched more safely
  • reception on the background of antibiotics, enzyme preparations, vitamins and immunomodulatory drugs.

Due to its properties of parasitism within the cells, for the treatment of chlamydia is necessary group of antibiotics, pre-stimulation of an exit of the parasite from the cells to the drugs could affect him. Each case requires an individual treatment plan based on the period of pregnancy, the severity and nature of the process, as well as localization of the pathogen and the duration of the infection. It is also important to take into account the sensitivity of the parasite to drugs, as determined in laboratory studies (crops with the definition of sensitivity). Definitely need to take into account the presence of comorbidities.

Immunomodulators in pregnancy is prescribed with caution and not for all women. This is due to the functioning of the immune system on the background of gestation associated with gestation.

It is also shown receiving enzyme preparations and substances, normalizes metabolism in cells and tissues. Due to them actively there is a process of regeneration of damaged mucous membranes, they reduce the risk of allergic and negative reactions to the antibiotics help in providing anti-inflammatory and decongestant effect. These products help to reduce the concentration of antibiotics taken by almost 40%, reinforcing their effects in the tissues which helps in more active fight with infection. As the recovery and elimination of the infection is shown taking a multivitamin and mineral supplements to restore the damaged mucous tissues.

How to determine whether the infection is cured?

After a full course of treatment is necessary control tests, which will reflect the effectiveness and usefulness of therapy.

They can be made in several versions, to confirm definitively fixed and if chlamydia out of the body completely:

  • 2 weeks after your last dose of antibiotics is sowing flora with the identification of chlamydia. But this method does not give 100% reliability, because the parasite can during the intake stroke to be inside the cell and not be detected.
  • along with him, carried out a study of PCR detection of DNA of chlamydia or direct fluorescence (PIF) with the identification of antibodies to chlamydia. They are also shown in the dynamics after 3-4 weeks after the end of therapy to evaluate the efficacy of interventions.

Sometimes they can lead to false-positive results due to presence of dead parasites is not yet fully removed from the body.

Pregnancy after chlamydia infection

The presence of chlamydia, especially long-term treatment and occur chronically, can significantly harm the female body. This often leads to inflammatory processes in the genital area, even though external symptoms may not be. Often the inflammatory process, which is formed due to chlamydia, leads to irreversible consequences for the organism that threatens the formation of adhesions in the fallopian tubes and infertility. Dangerous ectopic pregnancy, which is likely on the background of chlamydial lesions of the appendages and tubes. If chlamydia was migrated and thoroughly treated, it may not affect the conception and gestation, if not lead to chronic endometritis or other organ.

Methods of prevention of chlamydial infection with gestational age

The basis of prevention of chlamydial infection is pregnancy planning and preliminary full examination prior to conception. It is necessary to identify all possible infections and their active treatment. One should also remember about the protection from infections sex, using barrier methods of contraception. Important examination of both partners, even if no signs of infection to anybody, because chlamydia and other infections tend to be hidden within. The detection of the causative agent planning pregnancy should be postponed for 2-3 months to completely treated and pass the control tests. This will protect the woman and baby from dangerous disease.

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