Features of infection with ureaplasma during pregnancy and the consequences for the child. The effect of ureaplasmosis on pregnancy: the danger of ureaplasma for women and children, treatment and prevention What is ureaplasma in pregnant women

Ureaplasmosis is a sexually transmitted infection. The causative agent of this pathology, ureaplasma, inhabits the vagina of healthy women in 60% of cases and occurs in every third of a newborn girl. Pathogenic microflora can live in the body for years without causing harm to health and without causing any symptoms.

Ureaplasmosis during pregnancy, at a time when the woman's body is as weakened as possible, can pose a serious threat to both the expectant mother and the child.

Clinical manifestations

The main problem of the disease is untimely diagnosis. During pregnancy, serious changes occur in a woman's body that make it difficult to identify many pathologies, since the symptoms are perceived by patients as part of the process of bearing a child. As a result, women see a doctor late and self-medicate at home. But you can recognize ureaplasmosis by the following signs:

• Vaginal discharge becomes cloudy.
• The appearance of discomfort in the genital area, itching, burning. Symptoms are aggravated by urination or taking warm water procedures (shower, bath).
• Sensation of spasm or aching pain in the lower abdomen.
• A strong feeling of discomfort or pain during sexual intercourse.

Ureaplasma multiplies in the mucous membranes of the human body. In 90% of cases, this is the genital area, but under some circumstances (oral sex), pathogenic microflora affects the larynx, causing symptoms resembling a sore throat. Affecting internal organs, such as the bladder, a pregnant woman may be bothered by signs of cystitis - frequent, painful urination.

Attention! Experts warn that incorrect self-diagnosis and self-treatment lead to neglect of the pathology, which is easily treatable in the early stages. An untimely visit to a doctor can cause irreversible harm to the body of the mother and the unborn child.

Sources of infection

Among doctors, there are still disputes about whether there is such a disease as ureaplasmosis. Note that at present this pathology is not included in the International Classification of Diseases.

The reason for this was that there is not a single reliable source that would prove the existence of ureaplasmosis.

The bacterium - ureaplasma, is an integral part of the normal microflora of the body.

But under certain conditions, especially when inflammatory processes occur in the body, an increased amount of ureaplasmas is noted, which served as an assumption of its negative impact. That is why ureaplasma is called conditionally pathogenic - dangerous only with excessive reproduction.

There are two main routes of infection:

1. Unprotected sexual intercourse with a carrier of the disease, including oral sex.
2. Intrauterine infection - infection from mother to fetus.

Infants are predominantly female. Boys suffer from this disease much less often and are able to get rid of the pathology on their own, without the use of medications. Additional sources of infection can be:

• Wearing someone else's underwear.
• Use of other people's toiletries: washcloths, towels, razors for intimate hair removal.
• The risk of infection increases when visiting: public toilets, baths, solariums.

These sources of infection, according to doctors, are unlikely, but they cannot be ruled out. Infection with pathogenic microflora does not guarantee the development of ureaplasmosis - the bacterium may not manifest itself for years. For the progression of the disease, excessive reproduction of the microorganism is necessary. The main motivating factor for the active reproduction of bacteria is considered to be a decrease in human immunity, which is observed in the following situations:

• transferred infectious diseases;
• the presence of chronic diseases;
• bad habits;
• irrational nutrition;
• changes in the hormonal background of the body as a result of pregnancy, the presence of diseases of the endocrine system, the use of hormonal drugs;
• sedentary lifestyle.

Attention! The opinion that ureaplasmosis can be infected by airborne droplets has not found scientific confirmation. It is noted that the bacterium is unable to live and multiply in the external environment.

The effect of ureaplasma on pregnancy

Despite the apparent frivolity of the disease, in reality, ureaplasma is very dangerous, especially during pregnancy. The inflammatory processes that the bacterium causes lead to disruption of the genitourinary organs.

The most difficult for women in the situation are the risk of premature birth or loss of a child.

Ureaplasma changes the structure of the mucous membranes, which negatively affects childbearing. This pathology is considered one of the common causes of miscarriages or premature births.

Diagnostic procedures

Diagnosis of pathology is included in the general examination of pregnant women when they are registered in the antenatal clinic. Also, tests can be ordered at the personal request of the patient at any time. The main methods of diagnosing the disease are:

• Polymerase chain reaction - PCR. Diagnostic method of molecular biology, which allows to detect the DNA of pathogenic microflora. This examination reveals the presence of bacteria, and not their number, which makes it impossible to prescribe an effective method of therapy.
• Bacterial inoculation is the cultivation of microorganisms from a laboratory sample taken in a nutrient medium favorable for them. The method allows you to find out the dynamics of the growth of a colony of pathogenic microflora, the strain of bacteria and their sensitivity to various drugs.

Sowing takes several days and is considered the main method of selecting an individual method of treating pathology. To obtain accurate information, before taking tests, pregnant women are advised to adhere to the following rules:

• Two days before the test, you should refrain from any intimate relationships.
• Patients are prohibited from using tampons during this period. Also, it is not necessary to resort to excessive cleaning of the genital mucosa, to perform the douching procedure.
• It is not recommended to use any medicines, including local, external actions.
• On the day of the test, patients should completely abandon intimate hygiene.

Such rules contribute to minimal distortion of the state of the microflora of the genital mucosa and allow you to get more accurate examination results.

Attention! If a pathology is detected already during pregnancy, doctors, in order not to harm the fetus, are forced to abandon the use of some effective drugs. Experts strongly recommend planning a pregnancy in advance and undergoing an examination for ureaplasmosis even before the conception of a child.

Treatment of ureaplasmosis

The main method of drug therapy is the use of antibacterial agents. Treatment must be completed by all sexual partners at the same time, otherwise the therapy will not give the proper result and the next infection with ureaplasma will occur at the next unprotected intimacy.

Attention! All sexual partners should be treated at the same time.

The general course of therapy can be divided into three main stages, which are as follows:

• Normalization of the microflora of the body.
• Relief of provoking factors in the development of pathogenic microflora.
• Restoration of human immunity.

The course is prescribed taking into account the individual characteristics of the organism, the course of the disease, the age of the patient. After completion of treatment, a control laboratory analysis is carried out.

Attention! The presence of a diagnosis - ureaplasmosis, is not an indication for termination of pregnancy.

Antibiotics

Antibacterial drugs are the main means of combating this disease. During pregnancy, they begin, as a rule, from 22 weeks - by this period, the internal organs have already formed in the fetus. In the early stages, taking antibiotics can harm the baby or cause a miscarriage. The most common antibacterial drugs for the treatment of ureaplasmosis include:

• Josamycin.
• Doxycycline.
• Tetracycline.
• Erythromycin.

Medicines can be prescribed exclusively by the attending physician on an individual basis. Only a specialist on the basis of laboratory tests can choose the safest and most effective drug. The course of treatment takes 2 weeks.

Immunomodulators

Ureaplasmosis begins to develop in a person not at the time of infection with bacteria, but in the presence of provoking factors that lead to excessive reproduction of pathogenic microorganisms. One of the main factors is a decrease in immunity, and in order to strengthen it, a number of immunomodulatory drugs are prescribed together with the intake of antibacterial agents:

1. 1. Immunoglobulin called Ureaplasma Immun, which is made from purified human blood plasma. Helps to increase the body's resistance to ureaplasma. Contraindicated in persons allergic to protein.
   2. Interferon. Allows you to enhance the effect of antibacterial agents.
   3. Stimulants of endogenous interferonization, activating the body's own defenses, like Levamisole, Cyanocobalamin.
   4. Cellular immunity stimulators, like Mielopid, Timalin.

Restoring agents for the vaginal microflora

The vaginal microflora is a special ecosystem of the female body, which provides protection for the reproductive organs. As a result of ureaplasmosis and taking antibacterial agents, an imbalance of normal microflora occurs. To restore it use:

• Vaginal probiotics. Preparations containing sour-milk or lactobacilli: Laktogin, Gynoflor, Ecofemin.
• Candles for dysbacteriosis: Bifidumbacterin, Lactobacterin, Kipferon.
• Tablets for the treatment of dysbacteriosis: Normoflorin.

All medicines should be taken only after consultation with your doctor. To enhance the effect of drugs and suppositories, it is recommended to include fermented milk products in your diet - they have an additional positive effect on the vaginal microflora and the whole body as a whole.

Dangerous consequences of the disease

Despite the fact that ureaplasma belongs to opportunistic bacteria, and ureaplasmosis is not included in the International Classification of Diseases, do not underestimate it. Late diagnosis of the disease or improper self-treatment, especially during pregnancy, can lead to negative consequences for both the mother and the child.

For mother

In addition to the risk of abortion and premature birth, for a woman there are a number of complications that ureaplasmosis can lead to:

• Infertility.
• Ectopic pregnancy.
• Infection of the fetus, which can lead to negative consequences for the child's body in the first years of life.
• Diseases of the kidneys, liver.
• Weakened immunity.

Timely detection of pathology and therapeutic measures taken are the key to the health of parents and their children.

For kids

The child, being in the womb, is protected from pathogenic microflora by the placenta. Infection occurs during childbirth, during the exit of the child through the birth canal. Boys are much less susceptible to the disease than girls. The consequences may be as follows:

• defective formation of the internal organs of the baby;
• diseases of internal organs;
• decrease in immunity.

Ureaplasmosis transferred in infancy dramatically increases the risk of developing the disease in a child in the future. It is the mother who bears full responsibility for the future health of the baby.

Preventive measures

Prevention methods are necessary not only to prevent pathology, but also to exclude repeated relapses of the disease. The main ways to help avoid infection include the following rules:

• Regular preventive examination of both sexual partners.
• Indiscriminate intimacy should be avoided.
• Use of contraceptives during sexual intercourse.
• Compliance with personal hygiene measures.

To prevent recurrence of the disease, it is recommended to reconsider your lifestyle: give up bad habits, take measures to strengthen immunity. This is well facilitated by sports, the rejection of alcohol and smoking.

Ureaplasmosis during pregnancy can occur against the background of a decrease in the protective functions of the body. The infectious disease is predominantly sexually transmitted. The causative agent of the violation inhabits the woman's vagina, it can be in the body for years, but only manifest itself when the symptoms favorable for this are created.

What is ureaplasmosis in women during pregnancy

Pregnancy can become a provoking factor for the exacerbation of chronic diseases and the activation of opportunistic microflora. Due to this, new diseases occur, they negatively affect the fetus and affect the condition of the pregnant woman.

Ureaplasmosis during pregnancy is diagnosed in at least 40% of cases.

The causative agent of the disorder belongs to the mycoplasma family, it is an opportunistic pathogen. This means that the pathogen can stay in the body for a long time and not cause discomfort to the carrier. Ureaplasmas do not belong to bacteria or viruses, they are recognized as an intermediate form. A characteristic feature of these organisms is the ability to synthesize urease, this enzyme instantly breaks down urea and forms ammonia.

The causative agent of ureaplasmosis is able to adapt to the stimulus, therefore it rapidly multiplies in the cells of the genital organs. Scientists have identified 7 types of ureaplasmas, but only 2 are dangerous to humans. The disease is included in the list of sexually transmitted infections, but this method of infection is not the only one.

Ureaplasma exists in the body of every woman, but in the presence of inflammation in the body, it begins to actively multiply and have a negative impact on the patient's condition. Basically, infection occurs during unprotected intercourse or during the prenatal period. Also, the cause of the development of ureaplasmosis can be the use of someone else's underwear and other personal hygiene products. Household mode of infection is unlikely, but it cannot be ruled out.

During pregnancy, serious hormonal changes occur, they can affect overall well-being and cause the development of ureaplasmosis. Also, a decrease in immunity occurs with:

• the presence of chronic diseases;
• abuse of alcohol or smoking;
• completed infectious diseases;
• malnutrition;
• disruption of the endocrine system or the use of hormonal agents;
• leading a sedentary lifestyle.

In the external environment, ureaplasma is not able to multiply, therefore, infection by airborne droplets is excluded.

Is it possible to get pregnant with ureaplasmosis

During ureaplasmosis, a woman's reproductive functions worsen, but there is a chance of successful conception. You should not postpone a visit to the doctor if a pathology is detected, since there is a risk of intrauterine infection of the child, the development of a chronic form of the disorder and infertility.

If you want to give birth to a healthy baby, you will need to undergo treatment and then resume trying to have a baby.

Problems with pregnancy in the event of ureaplasmosis occur in 60% of cases, since the bacterium affects the genitourinary system, the uterine mucosa and the vaginal microflora. Experts advise to complete therapy before pregnancy, otherwise a miscarriage may occur. If a woman could not influence this process and pregnancy occurred during an exacerbation of ureaplasmosis, then she will be prescribed antibiotics and other auxiliary drugs to normalize her health.

Is it dangerous during pregnancy

With the active reproduction of ureaplasma, exposure to opportunistic microflora causes serious harm to health. The most common negative consequence is the transition of the disorder to a chronic form. This means that a woman will regularly suffer from exacerbations of ureaplasmosis.

The female reproductive system is also affected. Ureaplasmas provoke an inflammatory process in the vagina and uterus, and therefore the fertilized egg cannot be fertilized. Therefore, infertility can become a complication of ureaplasmosis. Attempts to conceive a child can result in an ectopic pregnancy. The danger of such a consequence increases with the defeat of the fallopian tubes.

The effect of ureaplasmosis on the fetus

In the early stages of pregnancy, ureaplasma penetrates through the anatomical membrane into the amniotic fluid and affects the child. In early pregnancy, there is a high risk of embryo freezing. In this case, the infection affects the formation of the child and leads to a halt in its development, which leads to death. The disorder can affect the baby's lungs. In this case, after childbirth, broncho-pulmonary dysplasia or respiratory failure is diagnosed.

In some cases, pregnant women with ureaplasmosis experience premature birth or miscarriage. This occurs with the active spread of the inflammatory process. Concomitant diseases also have an impact. Among them are endometritis, salpingitis, oophoritis. The child experiences a lack of oxygen and nutrients, so it lags behind in development and does not gain weight.

Symptoms in a pregnant woman

Late diagnosis is the main problem of ureplasmosis during pregnancy. When carrying a child, significant changes occur in the body. A woman perceives all the symptoms as part of the gestation process, so she does not report them to the doctor. It is possible to recognize ureaplasmosis by the following manifestations:

1. Abundant discharge from the vagina appears, they acquire a cloudy color and an unpleasant odor.
2. Discomfort appears in the genital area. The woman will experience itching and burning. Unpleasant symptoms are aggravated during urination, bathing or showering.
3. Pain during intercourse. Having sex will not bring pleasure due to disturbances in the body.
4. Spasms and aching pain. These signs appear in the lower abdomen. They may resemble the sensations during the onset of menstruation, if the woman had a pronounced PMS.

A favorable place for the reproduction of ureaplasma are the mucous membranes. In most patients, the disorder is located in the genital area. But when infected during oral sex or when infected through personal hygiene products, ureaplasmas can affect the larynx. In this case, the same symptoms appear as during a sore throat.

During the progression of ureaplasmosis, microorganisms spread to other internal organs.

First of all, the bladder is affected. During this, the woman is faced with painful urination and regular false urges to go to the toilet.

How is it treated during pregnancy

Therapy to eliminate ureaplasmosis is prescribed by a doctor based on the patient's condition and the results of laboratory tests. To eliminate the pathology, it is necessary to use antibiotics and other medicines that can harm the child. Therefore, the treatment uses an individual approach.

Usually, doctors prescribe medications only when there are signs of an inflammatory process and microorganisms are detected in a titer that exceeds the norm. In the absence of complaints, the disease is simply observed. Both partners must be treated, otherwise taking medication will not give the desired results. Sexual contact is prohibited while taking medication.

The course of therapy is divided into 3 stages. First, drugs are selected to normalize the microflora of the body, then the doctor stops the provoking factors that influenced the development of the disorder, and at the final stage increases the immunity of the pregnant woman.

During the treatment of ureaplasmosis, antibacterial drugs are used. Therapy is prescribed from the 22nd week of pregnancy, so as not to harm the baby. By this time, the internal organs are already forming in the fetus, so antibiotics have a minimal effect. For this purpose, it is most often prescribed:

• erythromycin;
• azithromycin;
• tetracycline.

The medicine is selected by the attending physician, the duration of therapy does not exceed 2 weeks.

Decreased immunity is the main factor contributing to the development of ureaplasmosis, so the patient is prescribed immunomodulators during treatment. The medicine is selected depending on the goal. To increase the body's resistance, immunoglobulin is prescribed. It consists of purified blood plasma and helps quickly. To stimulate cellular immunity, thymalin or myelopid is prescribed. In order to enhance the action of antibiotics, interferon is used.

Local preparations are also used to normalize the vaginal microflora.

Vaginal probiotics, tablet preparations and suppositories for dysbacteriosis are used. After completion of therapy, a control laboratory test is prescribed, it allows you to verify the effectiveness of the medication.

Precautions and Prevention

To prevent ureaplasmosis during pregnancy, you should take a responsible approach to this process and plan conception. Sexual partners are encouraged to regularly take tests and check their health. Also, doctors recommend carefully monitoring compliance with personal hygiene standards and using contraceptives during intimacy.

During pregnancy, the health of the expectant mother is under close control. Regular laboratory tests and hardware procedures are carried out. If conception is planned in advance, the woman first undergoes a complete medical examination, which allows to exclude pathologies or inflammatory processes.

In most cases, diseases and inflammations are diagnosed already during pregnancy. Of particular danger are various infections of the genitourinary system. What is ureaplasmosis, what danger does it carry for the health of the expectant mother and baby? How is pathology diagnosed and treated?

Characteristics of the disease

Ureaplasmosis is an infectious disease characterized by inflammation of the genitourinary system. The causative agent of pathology is ureaplasma. This is the simplest bacterium, which was discovered in the 70s.

Initially, the infection was classified as STDs (sexually transmitted diseases), but over time and the development of medicine, the opinion of doctors has changed. Ureaplasmosis has become a simple sexual infection.

Bacteria do not have cell walls. It is an opportunistic pathogen. This means that ureaplasma can live in the body for a long time without causing any problems and without showing symptoms. That is why very often the pathogen is diagnosed only during routine examinations. Obvious signs of the inflammatory process are manifested in the presence of a kind of catalyst.

This means that there must be several decisive factors that trigger the pathogenic activity of the bacterium. Inflammation develops against the background of a reduced immune defense of the body. Usually, another genitourinary infection occurs in parallel with ureaplasmosis.

Ways of infection

The disease refers to women, but also occurs in men. An adult woman can become infected in one way - through sexual intercourse (both vaginal and oral). Ureaplasma during pregnancy is a serious pathology, since it is likely to be transmitted to the baby and affect his health.

The infection is common in newborn babies, especially girls. The ratio of infected girls to boys is 5:1. It is highly likely that a woman will pass the disease on to her baby during childbirth.

Less often, ureaplasma during pregnancy is transmitted in other ways, for example, through the placenta. Sometimes microorganisms penetrate through the amniotic sac into the amniotic fluid, and then into the lungs of the fetus. Infection by household means (through touch, personal hygiene items, common bed linen) has not been scientifically proven.

Varieties of microorganisms

More than 10 types of microorganisms are distinguished. Only 2 of them lead to pathological processes and require treatment.

Varieties of pathogenic bacteria:

1. Ureaplasma parvum. Ureaplasma parvum during pregnancy is a less dangerous type. Bacteria concentrate on the mucous membrane of the genitals and lead to inflammation. Sometimes pathology causes the formation of stones and a decrease in immune defense.
2. Ureaplasma urealiticum. Aggressive type of bacteria. It penetrates not only into the mucous membranes, but also into the blood. Reduces immunity, in women can lead to infertility.

Other types of infection are not dangerous. They can be in the body without causing problems. For example, ureaplasma spices is part of the normal and healthy microflora of a woman.

Symptoms of ureaplasmosis

Symptoms can be blurry and indistinct, which confuses many pregnant women. Also, the signs depend on the location of the inflammation, and how far the infection has advanced. After the incubation period, the woman has early symptoms. They are characteristic of the disease, but not always informative.

First, 2 main symptoms appear - inflammation of the mucous membrane and whitish discharge. However, both of these signs are often attributed to pregnancy or thrush. Many women do not consider it necessary to see a doctor, they consider it a trifle and self-medicate.

After the symptoms subside, the infection "falls asleep" until conditions favorable for it occur. With stress, reduced immunity, chronic fatigue, microorganisms wake up and lead to serious problems.

Symptoms of pathology depending on the location of inflammation:

1. Damage to the tissues of the vagina. The patient has colpitis, that is, inflammation, as well as white dense discharge.
2. Uterus. When the infection has reached the uterus, the pregnant woman is tormented by pain in the lower abdomen. This is indicative of endometritis.
3. Bladder. It is characterized by the manifestation of cystitis. The woman feels frequent urge to urinate. The process itself is not very productive and hurts.
4. Oral cavity. If the cause of infection was oral contact, there will be standard signs of a sore throat.

How does infection affect pregnancy?

What disease threatens the fetus? How does it affect the process of bearing and the health of a woman? This question worries all women.

Previously, it was believed that urogenital infections are not compatible with pregnancy, and that a woman should have an abortion. Everything has changed at the moment. Doctors are sure that pregnancy with pathology is quite possible. With proper and timely treatment of ureaplasma, the child is born completely healthy. However, dangerous consequences cannot be ruled out.

Consequences for a woman

Possible consequences for a woman:

1. Reproductive dysfunction. Pathological processes in the vagina and cervix do not allow the embryo to gain a foothold on the uterine wall. If left untreated, infertility is possible.
2. Inability to bear a child. This includes both premature birth and fetal fading.
3. Increased risk of ectopic pregnancy. This is likely to occur when an infection occurs in the fallopian tubes.
4. Postpartum endometritis (inflammation of the tissues of the uterus). After childbirth, the risk of inflammation of the uterine membrane and appendages increases.

Consequences for the child

What are the possible consequences for the baby? The potential threat depends on when the baby became infected - during fetal development or during childbirth.

Complications in intrauterine development:

1. Fetal blood infection. This rarely happens, as the mother's body reliably protects the baby. This happens if the mother became infected at an early stage, when the embryo does not yet have its own blood flow. With a small probability, serious pathologies are possible.
2. miscarriage or premature birth. Ureaplasmosis softens the walls of the uterus, which complicates the process of bearing. In the early stages there is a risk of miscarriage, and in the later stages there is a high risk of premature birth.
3. Lack of oxygen and essential nutrients. This happens when infection occurs in the 2nd or 3rd trimester.
4. The consequences of treatment. During therapy, antibiotics are necessarily used, which are undesirable for the fetus.

If a child is infected during childbirth, the consequences may be as follows:

1. pneumonia;
2. conjunctivitis;
3. pyelonephritis or nephritis;
4. bronchopulmonary dysplasia;
5. meningitis.

Is it possible to conceive a child with ureaplasmosis?

All experts say unequivocally - it is quite possible to conceive a child. There are no physiological barriers in ureaplasmosis. However, earlier it was already said about the possible danger of developing pathologies, both for the fetus and for the expectant mother.

Pathological processes in the vagina, cervix and pharynx of the uterus or appendages can prevent conception. There is a chance that the embryo will not be fixed. However, ureaplasma parvum will not interfere with a normal and healthy pregnancy. It is best to conduct a medical examination before conception.

Diagnosis of the disease

The ideal option is to undergo a diagnostic study before planning a pregnancy. If a disease is detected, it is possible to resume attempts at conception only after 2-3 months. In this case, all drugs will definitely come out of the body.

If a woman is already pregnant, diagnostics are prescribed when there is a suspicion of a problem. Diagnostic measures are completely safe.

Examination methods:

1. PCR (polymerase chain reaction). Doctors take a swab from the affected area. The method allows to determine the presence of pathogenic DNA. It does not show the number of microorganisms.
2. Bacteriological culture. Allows you to determine the level of resistance of bacteria, as well as their exact number. The norm for the content of conditionally pathogenic microflora is less than 10,000 per 1 ml.
3. Serological examination, analysis for antibodies. For this, blood is taken from a vein. The presence of certain antibodies or antigens is determined. It is used in the presence of severe symptoms.

Treatment Methods

How to treat ureaplasma at different stages of pregnancy, so as not to harm either mother or baby? You need to know that therapy is due to both partners. Otherwise, after recovery, the woman will again become infected from the man.

For the duration of therapy, you must refrain from sexual activity or be sure to use a condom. Otherwise, a vicious circle will turn out - the partners will take turns infecting each other.

The only way to treat ureaplasmosis is to take antibiotics, because the infection is bacterial in nature. It is impossible to do without antibacterial drugs. The whole difficulty lies in the fact that antibiotics are highly undesirable during pregnancy.

To reduce the risk of side effects, therapy is started no earlier than 20 weeks. During this period, the fetus has already formed vital organ systems, so the negative impact of drugs is reduced.

Many women do not understand why doctors prescribe a long list of drugs that are not directly related to the infection. Among them are immunomodulators, immunostimulants, probiotics and other means for the normalization of microflora.

Antibiotics act indiscriminately, they destroy all bacteria, including beneficial ones, and reduce the body's immune defenses. He becomes susceptible to infections and diseases. The condition of the expectant mother is deteriorating. That is why they prescribe drugs that will support the immune system. Probiotics will help to avoid dysbacteriosis, normalize the balance of microflora.

Prevention measures

To avoid the development of ureaplasmosis and other urogenital diseases, you need to follow preventive measures and be attentive to your health. First of all, plan your pregnancy in advance and undergo a medical examination and treatment.

Casual sex should be avoided. If you are unsure about your partner, use condoms. Twice a year it is necessary to visit a gynecologist for examination and testing. This will help to diagnose any inflammation in time. Women's health is extremely important.

It is forbidden to self-diagnose and treat pathology. Self-medication has a negative impact on health. Firstly, it will not help, and secondly, it can harm mother and child.

Content

Ureaplasma during pregnancy is a pathogenic infection in the body of a woman, which should be treated very carefully during the period of bearing a child. It has been proven that this bacterium is part of the vaginal flora in 70% of women, without causing any problems. However, it is worth changing the immune system, as the number of bacteria grows. In this case, they say that a woman from a carrier of the infection turns into a sick woman.

What is ureaplasma during pregnancy

Ureaplasma (ureaplasma) in pregnant women often causes a disease called ureaplasmosis, which can cover all organs of the genitourinary system. They can be contracted during pregnancy, before and after. The first option is the most undesirable. Therefore, if you are planning to replenish the family, you must undergo an examination, taking tests for the presence of sexually transmitted infectious diseases.

Symptoms

Symptoms of ureaplasma during pregnancy are no different from signs of infection in the normal state. Women in position rarely attach importance to them, they are inexpressive and can be attributed to changes that occur during the period of bearing a child. The first symptoms of ureaplasmosis are more abundant white vaginal discharge, but pregnancy in the first trimester and thrush proceed with the same changes. After some time, the symptoms disappear, but after three to five weeks they return again. This means that ureaplasmosis has passed from an acute form to a chronic one.

If the infection spreads to the uterus, then the woman, in addition to the discharge, begins to complain of pulling pains in the lower abdomen. If inflammation occurs in the bladder, ureaplasma during pregnancy causes cystitis, characterized by frequent urination and burning. In men, the disease is more pronounced. The first stage in the development of ureaplasmosis in representatives of the strong half of humanity is accompanied by discomfort in the urogenital canal. If a woman suspects something is wrong with her, she should ask her partner about the presence of suspicious symptoms.

Causes

You can only become infected with ureaplasmosis through sexual contact, and this also applies to oral sex. If we talk about other STDs (sexually transmitted diseases), which can be caught in a bath or through a wet towel, then this is excluded in the case of ureaplasmas. Men and women who are carriers of the infection may not even be aware of the infection, but only until such time as changes occur in the body, associated, for example, with a decrease in immunity, taking antibiotics, etc. In this case, you should immediately consult a doctor.

Is it possible to get pregnant with ureaplasma

Ureaplasmosis can get sick both during pregnancy and before it. The disease does not carry any physical obstacles to the process of conception. Moreover, infection in most cases occurs imperceptibly, that is, asymptomatically. Another thing is that ureaplasma in women during pregnancy adversely affects both her health and the development of the fetus. For this reason, gynecologists strongly recommend being tested for STDs and ureaplasma just before planning a pregnancy and every time you change your sexual partner.

Is ureaplasma dangerous during pregnancy

Any infectious diseases, including ureaplasma, during pregnancy can adversely affect the development of the fetus in the womb of a woman. Especially dangerous is infection in the first trimester, when the baby's internal organs are rapidly forming. This can lead to premature birth, the threat of miscarriage and other serious problems during gestation.

Effects

The consequences of ureaplasmosis negatively affect the mother and child in the postpartum period and during pregnancy. If there is any suspicion of infection with an STD, you should immediately contact a gynecologist for testing, groundless experience may not have the best effect on the growth and development of the child during pregnancy. Calmness should be maintained even with a positive test result.

For a child

A child in the womb can become infected with ureaplasmosis in two ways. Depending on this, doctors divide this disease into congenital, which occurs during pregnancy, and neonatal, when the child's symptoms occur in the first 28 days of life. Both options are undesirable. If ureaplasma is detected in a newborn baby, its treatment should be started immediately.

Why is ureaplasma dangerous during pregnancy for a baby in the womb? This is fraught with hypoxia, tone, loosening of the cervix and other pathologies, up to termination of pregnancy. All this in the end, without control, can lead to miscarriage, early birth, and developmental disorders of the fetus. The female body protects the child from various infections, the placenta is considered a reliable barrier against infection. Infection in the womb occurs very rarely, which cannot be said about the process of childbirth itself, when the baby passes through vertical pathways, becoming infected from the mother.

For woman

What harm can ureaplasmosis bring during pregnancy for a woman? Ureaplasma in pregnant women are bacteria that cause an inflammatory process at the breeding site. Infection at any time can migrate from the vagina to the cervix and the uterus itself. If the fetus is reliably protected by the placenta during the illness, this does not mean that the female organs are safe and complications are excluded. On the contrary, the entire genitourinary system, including the kidneys, can feel the influence of the disease.

Diagnostics

Diagnosis of ureaplasma by the method of conventional bacteriological culture will not give an answer whether a woman is sick or not, since a certain amount of these bacteria is a completely normal state of the vaginal microflora. However, such a diagnosis already indicates a possible ureaplasmosis. With a positive result, the gynecologist will refer the patient for additional tests, which are carried out using the following methods:

• DNA diagnostics or PCR method (polymerase chain reaction). This is an ultra-sensitive analysis, with which you can detect one fragment of the genetic material of the pathogen, determine the number of bacteria in a certain area.
• Direct immunofluorescence method. It is based on the determination of antibodies that are present in the blood to the simplest ureaplasma.

Treatment

Why is it so important to diagnose STDs before planning a pregnancy? Why is it impossible to cure ureaplasmosis during pregnancy and thereby prevent possible infection of the child during childbirth? Everything is simple. It is possible to cure ureaplasma only with the help of antibiotics, which, as you know, are not prescribed during pregnancy.

If a woman with ureaplasmosis became pregnant unplanned or the infection occurred while carrying a child, then gynecologists advise not to carry out hard treatment, you just need to keep the course of the infection in a stable state with the help of more gentle means. These methods include douching, washing, baths using simple and safe means that will not interfere with taking drugs, but only enhance the effect:

• Furacilin. This is a universal antimicrobial drug that is used to treat many infections and viruses, including ureaplasmosis, which can occur during pregnancy. To prepare the solution, you need to dilute two yellow tablets of Furacilin in warm water and carry out the washing and douching procedure.
• Medicinal herbs. Chamomile, calendula, string, thyme - all these plants have anti-inflammatory and antimicrobial effects and are active against ureaplasmosis. Pour two tablespoons of dried herbs with half a liter of boiling water, let it brew for 30 minutes under the lid, then strain through gauze, dilute with five liters of warm water, take a sitz bath. The same undiluted infusion is recommended to wash or douche.

Preparations

Pregnant women with ureaplasmosis should take vitamins and immunomodulating agents. Nothing fights an infection like a person's immune system. It is impossible to drink any medications on your own, only the attending physician can prescribe them, otherwise, instead of a positive result with such treatment, you can get even more problems. It will not be superfluous to study the instructions attached to the medicines. Here are some of the resources:

• T-activin;
• Timalin;
• Bifidumbacterin;
• Colibacterin;
• Lactusan.

If the risk to the fetus from ureaplasmosis exceeds the possible negative consequences of taking potent drugs, doctors prescribe drugs such as Rovamycin, Erythromycin, Vilprafen. All these drugs belong to the group of macrolides and are antibiotics. Let's take a closer look at one of them.

Wilprafen

Vilprafen is an antibiotic whose active ingredient is josamycin. It is produced in the form of oblong white coated tablets of 100 mg. Purpose: treatment of microorganisms of the upper and lower respiratory tract, skin infectious diseases, infections in dentistry and ophthalmology. It is prescribed for the treatment of sexually transmitted diseases such as syphilis, gonorrhea, gardnerella, ureaplasmosis. Contraindicated for people with liver problems. During pregnancy, it is prescribed only by a doctor from the second trimester.

Ureaplasma refers to conditionally pathogenic microorganisms. It enters the vaginal mucosa from a carrier partner sexually, and for a long time it may not make itself felt, being in a latent state. Very often, it is pregnancy that becomes the factor of influence that provokes the development of ureaplasmosis. How dangerous is the disease for the expectant mother and fetus? What are its symptoms? And how to treat an infection during pregnancy?

What is ureaplasmosis

There are more than thirty types of microorganisms on the vaginal mucosa. Most of them are beneficial lactobacilli, which form the basis of the normal flora of the female genital organs. The active development of pathogenic and conditionally pathogenic microflora is observed when, for some reason, the protective functions of the immune system weaken.

Ureaplasmosis is an infectious disease caused by the bacterium ureaplasma. Its constant presence on the mucous membranes of a healthy woman is uncharacteristic - the bacillus is classified as a transistor microflora of the human genitourinary system. The infection enters the body mainly through sexual contact and develops on the mucous membrane of the internal genital organs.

About half of the women and men on the planet are infected with this bacillus. Ureaplasma causes inflammation of the mucous membrane when the balance of the vaginal microflora is disturbed.

And this happens:

• with concomitant infection - infection of the mucosa with other pathogens (gardnerella, chlamydia, fungi of the genus Candida) changes the ratio of beneficial and pathogenic bacteria, which leads to the development of inflammation;
• with weakened immunity, including against the background of pregnancy;
• with frequent colds and hypothermia;
• with active sexual life and frequent washing (douching);
• with chronic fatigue, exhaustion of the body, after stress.

In scientific circles, to this day, there is a debate about the classification and pathogenicity of ureaplasma. The question of the influence of these microorganisms on the bearing of pregnancy also remains open.

Exciter characteristic

Ureaplasma parvum and Ureaplasma urealyticum are the smallest specific bacteria; in the classification of microorganisms, they occupy an intermediate position between unicellular microbes and viruses. They belong to mycoplasmas (Mycoplasmataceae), but are isolated in a separate genus due to their ability to split urea to ammonia.

Ureaplasmosis is diagnosed when the concentration of bacteria in a smear on the flora significantly exceeds the permissible norm. The presence of ureaplasma on the vaginal mucosa within the normal range is not an indicator of a disease, but only of infection. At the same time, a woman is a carrier of the infection and can infect her sexual partner.

Against the background of active reproduction of ureaplasma, inflammation of the mucous membrane of the internal genital organs develops, which is reflected in the indicators of the urogenital smear: it will reveal an increased content of leukocytes - immune blood cells that are designed to fight the inflammatory process.

How bacteria enter the body

Infection with ureaplasma in the vast majority of cases occurs sexually - with unprotected sexual intercourse. Moreover, oral sex can also cause infection, but in this case, the mucous membrane of the oropharynx will become the site of infection.

Household methods of transmission of the pathogen, when pathogens enter the mucous membranes while visiting a bathhouse or pool, a public toilet, swimming in open water, etc., are unlikely. Very rarely there are cases of bacillus infection through personal items.

During pregnancy, there may be several ways of transmitting ureaplasma infection from mother to child.

1. Ascending or vertical. From the vagina, ureaplasma spreads vertically into the cervical canal, uterus, and appendages. Then, through the amniotic sac, the bacteria penetrate into the amniotic fluid and lungs of the embryo. Infection in this way occurs more often in the early stages.
2. The transfer route. When bacteria enter the placenta from the mother's systemic circulation. Theoretically, this can happen at any stage of pregnancy.
3. Intranatal route of transmission of infection to the fetus. In the presence of ureaplasma in the mother's vagina, it is implemented much more often than previous methods. The mucous membranes of the child become infected during childbirth - during the passage of the birth canal.

The penetration of ureaplasma to the fetus by ascending and transplacental routes is very rare. After the birth of the child, a complete examination is carried out, including for the presence of a ureaplasma infection on the mucous membranes of the newborn (genital organs, nasopharynx, respiratory tract), upon detection of which treatment is prescribed immediately.

Intrauterine infection of the fetus most often occurs when a woman becomes infected with ureaplasma during pregnancy.

Video: when to treat ureaplasmosis - Dr. Komarovsky and gynecologist Sergey Baksheev

infection and pregnancy

After numerous studies, scientists came to the conclusion that ureaplasma may well cause miscarriage and pathologies of fetal development. And the impetus for the reproduction of bacteria on the mucous membranes is often precisely the conception and development of the child in the mother's womb.

The weakening of immunity during pregnancy is a physiological phenomenon. The protective functions of the immune system should not interfere with the implantation of the ovum into the uterine wall. But just at this time, the ureaplasma, which was previously in remission, can begin to actively develop, causing inflammation of the mucous membranes. It is important to cure ureaplasmosis in a future mother at the stage of pregnancy planning or before delivery. This will significantly reduce the risks of infection of the baby during childbirth and prevent deeper infection of the woman.

Ureaplasma in the early stages causes the development of chorioamnionitis (inflammation of the membranes of the fetus), bronchopulmonary dysplasia in the fetus. In the first trimester of pregnancy, with an acute infection and the development of inflammation, the formation of the embryo may stop and its intrauterine death may occur. Then a missed pregnancy is diagnosed.

In the second and third trimesters, against the background of inflammation caused by ureaplasma and deep infection of the mother's body, the cervix becomes loose, and the external pharynx softens and opens. Why does the expulsion of the fetus from the uterus begin prematurely - premature birth.

Against the background of ureaplasmosis, fetaplacental insufficiency develops - a deficiency of nutrients and oxygen from the placenta to the fetus. Why the child has intrauterine growth retardation, he is born prematurely - weak, "immature", with low weight. During childbirth, the baby passes through the birth canal, the mucous membranes of which are infected with ureaplasma. If the child was not infected in utero, the bacillus penetrates to him during childbirth.

When a newborn is infected intranatally, ureaplasma can affect not only mucous membranes, but also enter the bloodstream, provoking the development of a generalized infection in an infant - meningitis, pyelonephritis, pneumonia, sepsis. In the postpartum period, ureaplasmosis causes endometriosis (inflammation of the uterine mucosa), salpingo-oophoritis (chronic inflammation of the appendages, with ascending infection) in the mother, which in the future leads to infertility or the onset of an ectopic pregnancy.

Infection with ureaplasma during pregnancy (or detection of infection after conception) is not a reason for its termination. Timely diagnosis and a properly developed treatment strategy will help a woman bear and give birth to a completely healthy baby.

Video: ureaplasma, its effect on pregnancy and fetus - expert opinion

Types and symptoms of the disease

Referring to opportunistic microorganisms, ureaplasma after penetration into the mucous membranes can not manifest itself for a long time at all or give out very mild symptoms. Often it is discovered during a planned smear test for microflora, and the woman herself does not even suspect that she is a carrier of the infection. The incubation period after infection with ureaplasma lasts 4 weeks.

Then you may see:

• vaginal discharge - mucous, transparent or whitish, not very abundant (and more often in the morning), and therefore in most cases go unnoticed;
• itching and burning of the external genital organs - these sensations are the result of an irritating effect on the skin of vaginal discharge;
• cramps during urination - this symptom appears more often in men, but it also occurs in women;
• a feeling of discomfort during intercourse - ureaplasmas developing on the mucous membrane of the genital organs cause inflammation, swelling and increased sensitivity to mechanical stimuli;
• slight pains in the lower abdomen - harbingers of the beginning inflammatory process;
• rarely, an increase in body temperature and signs of intoxication of the body with the waste products of pathogenic microflora.

Just a few days later, the manifestations of the disease gradually weaken, and the infection settles on the mucosa in anticipation of favorable conditions for its development - primarily, weakening of local immunity. It may take several years before the next relapse.

Symptoms of ureaplasmosis differ depending on the individual characteristics of the woman's body, the stage of its development (acute, recurrent), location, complications of the course of the disease and concomitant infections. If the mucous membranes of the oropharynx are affected by ureaplasma, the bacteria cause a sore throat, which is accompanied by all its characteristic signs - redness and swelling, pain when swallowing, fever, and if a secondary infection joins, then purulent plaque.

If the mucous membranes of the genitourinary system are affected, the symptoms will differ as the infection spreads from the vagina to the uterus, bladder, and kidneys.

1. Ureaplasma can cause inflammation of the vaginal mucosa - colpitis (vaginitis). Symptoms of this pathology are redness and swelling of the vaginal mucosa, itching, discomfort, mucous or spotting, pain during sexual contact.
2. Getting from the vagina into the uterus, the infection causes inflammation of its walls - endometritis (after childbirth). Then the woman has severe pain in the lower abdomen, fever, foul-smelling discharge, signs of intoxication.
3. The inflammatory process caused by ureaplasma in the urethra and bladder has characteristic signs of urethritis and cystitis - frequent urge to urinate, itching and pain during the passage of urine, discharge from the urethra, redness of the urethra.
4. From the bladder, bacilli enter the kidneys, causing inflammation of the parenchyma and pelvis - pyelonephritis (rarely). Its manifestations are lower back pain, a violation of the outflow of urine from the kidneys, an increase in blood pressure, and edema.

The longer the infection stays in the body and the further (deeper) it penetrates, the worse it can be treated and the more complications it causes. Even being in a latent state, without exacerbation, ureaplasma creates a favorable background for the development of other pathogens.

Weak symptoms in the initial stages do not force an infected woman to see a doctor. As a result, the disease is diagnosed already when the inflammatory process caused by it is in full swing.

Diagnostics

In Russia today, without exception, all pregnant women are not examined for ureaplasmosis. Analyzes are prescribed for women who have a history (medical history) of premature birth or miscarriage, and also if the attending physician, when examining the expectant mother, suspects that she is infected with ureaplasma (taking into account the symptoms).

At the stage of pregnancy planning, it is recommended to take an analysis for ureaplasma for both spouses. To identify the infection, to determine the degree of infection and the sensitivity of bacilli to antibiotics, laboratory studies of biomaterial taken from the mucous membranes of the internal genital organs - a smear on the flora, a polymerase chain reaction is performed to detect the DNA of the bacillus, to determine antibodies to the ureaplasma antigen, blood is taken from a vein. The most reliable will be the results of different types of studies, the combination of which the doctor chooses.

PCR method

Polymerase chain reaction allows you to detect the presence of ureaplasma DNA on the mucous membranes of the internal genital organs. For the study, mucus samples (smears) are taken from the vagina, cervical and urethra. Already after 5 hours it is possible to draw conclusions about infection.

However, the degree of development of pathogenic microflora and its sensitivity to antibiotics cannot be determined by this method. The effectiveness of the treatment of ureaplasmosis also cannot be assessed using PCR, since traces of the pathogen's DNA may remain on the mucous membranes for another 2–3 weeks after therapy.
Bacteriological culture allows you to determine the degree of activity of ureaplasma and make an antibiogram

Culture method or bacteriological seeding

For laboratory research, morning urine is collected, and a urogenital smear is also made - the biomaterial is taken from the mucous membrane of the vaginal vaults, cervical canal and urethra. The collected samples are placed in an artificial nutrient medium (each separately), where microflora develops within 48 hours.

10⁵ bacteria in the field of view under a microscope is the norm for the content of ureaplasma in a smear, if this number is much higher, ureaplasmosis is diagnosed. Bakposev allows you to determine the degree of infection activity, the location of the inflammatory process caused by ureaplasma, and the sensitivity of pathogens to antibiotics. Based on the results of the analysis, the doctor selects the most appropriate drugs for the treatment of the disease. In addition, with the help of cultural analysis, it is possible to monitor the effectiveness of therapy over time.

Detection of antibodies in the blood or serological method

To determine the presence in the body of antibodies to the ureaplasma antigen, blood is taken from a vein for analysis. The characteristic structures of bacteria in the blood are detected to diagnose the causes of miscarriage, infertility in women, as well as the development of inflammatory diseases of the reproductive and urinary systems in the postpartum period.

The serological method is used to diagnose relapses of the disease. The control of the cure of ureaplasmosis is carried out after the end of treatment - 2-3 weeks later - by the cultural method and using PCR.

How to treat ureaplasmosis in a future mother

In the absence of serious complications and the threat of termination of pregnancy in the early stages, diagnosed ureaplasmosis in a future mother begins to be treated after 20 weeks, when the organs of the fetus are already fully formed. Since in most cases the infection of a child with ureaplasma occurs during delivery, ureaplasma should be treated before the onset of labor.

Many doctors consider it appropriate to start treating ureaplasmosis at 30 weeks (with a successful pregnancy). Then the risks of infection of the child during the passage of the birth canal will be minimal. If there is a threat of miscarriage or complications of the course of pregnancy develop, treatment of ureaplasmosis is started immediately, regardless of the duration of pregnancy.

Therapy of the disease necessarily includes antibacterial agents, which in the first trimester can cause disturbances in the development of the embryo. In parallel, treatment is also prescribed to the spouse (sexual partner) of the woman. For the duration of therapeutic measures, it is recommended to refrain from sexual intercourse. With the threat of abortion due to a progressive ureaplasma infection in the early stages, treatment is started immediately.

Therapy for ureaplasmosis in pregnant women is always complex, it can be carried out in a hospital or on an outpatient basis, with mandatory regular monitoring of effectiveness. The doctor selects the drugs individually, depending on the history, gestational age, stage and location of the disease.
If treatment of ureaplasmosis during pregnancy is necessary, it is started no earlier than 20 and no later than 30 weeks of the term

Treatment involves the use of:

• antibiotics - fluoroquinolones, macrolides (Erythromycin,) - to combat ureaplasma infection;
• drugs to restore the microflora of the intestinal and vaginal mucosa - Linex, Lacidophila, Bifidumbacterin - antibiotics kill not only pathogenic bacteria, but also beneficial ones, upsetting the balance of microorganisms, so mucous membranes have to be populated with useful lactobacilli to restore their protective function;
• vaginal suppositories - Hexicon, Terzhinan, Livarol - for the treatment and prevention of the development of a secondary infection;
• immunomodulators - Viferon, Interferon - to enhance the immune response to the development of pathogenic microflora in the body;
• medicines to improve placental blood flow - Magne B6 or iron preparations - in order to increase the delivery of nutrients and oxygen to the fetus to normalize growth and development processes;
• vitamin complexes - for the general strengthening of the body of the expectant mother and a speedy recovery - Elevit Pronatal, Vitrum Prenatal.

It is important to strictly follow the prescribed scheme and complete the course of treatment completely. Transferred ureaplasmosis does not form stable immunity, and therefore re-infection and the development of the disease are possible. After antibiotic therapy, it is necessary to check whether the treatment was effective.

Table: medicines for treatment

The control of the cure of ureaplasmosis in pregnant women is carried out:

• using a cultural diagnostic method - on the 7-8th day after the end of antibiotics;
• by polymerase chain reaction - 2-3 weeks after treatment.

In order to prevent the growth of bacteria on mucous membranes from the 14th week of pregnancy, the doctor may prescribe a Viferon suppository to a pregnant woman. Possessing immunostimulating properties, they prevent intrauterine infection of the fetus. What creates the prerequisites for the birth of a healthy, strong baby, even with ureaplasma found in the mother.

Photo gallery: drugs used as part of the complex therapy of ureaplasmosis in expectant mothers

Linex - a complex remedy for restoring the normal microflora of the intestinal mucosa and internal genital organs Bifidumbacterin - normalizes the microflora of the intestinal and vaginal mucosa during antibiotic therapy Erythromycin - an antibiotic approved for use in the treatment of ureaplasmosis during pregnancy Magne B6 - soothes, relaxes, relieves the tone of the muscles of the uterus, prevents abortion, improves placental blood flow and supply of useful substances to the fetus Hexicon - is used in the complex therapy of ureaplasmosis for the local treatment of infection Livarol - suppositories prescribed to prevent the attachment of a secondary infection in ureaplasmosis Viferon - a human interferon drug, an immunomodulating agent Vilprafen - an antibiotic prescribed for pregnant women for the treatment of ureaplasmosis Vitrum Prenatal - a complex of vitamins and minerals for pregnant women, which strengthens the immune system and speeds up recovery