Cytomegalovirus and pregnancy: a threat to the fetus
- Cytomegalovirus and pregnancy: a threat to the fetus
Cytomegalovirus affects fetal development can lead to congenital abnormalities.Cytomegalovirus and pregnancy are closely related to the problem of intrauterine infection and perinatal pathology.The most severe consequences - a neurological complications of varying severity, as well as the death of the fetus and newborn in the immediate postpartum period.
Cytomegalovirus - a very common virus, which can become infected each.Getting in the human body, CMV remains inactive due to suppression of the immune system - which is why most people infected with CMV have no symptoms.Cytomegalovirus spreads easily through body fluids: blood, bile, saliva, breast milk.A pregnant woman can infect the child virus - this condition is called congenital cytomegalovirus infection.
confirm the fact of cytomegalovirus infection during pregnancy helps the regular blood test.Ideally, perform a blood test is necessary before pregnancy - pregnant women can take several tests to determine the nature of cytomegalovirus infection (infection may be primary or repeat).
value of a viral infection in terms of obstetrics
After primary CMV infection is its carrier lifetime.The incubation period averages 60 days.Pregnancy refers to factors that trigger the activation of the virus.The most dangerous is that infection, which occurred for the first time in a pregnant woman at the early stages of gestation (the first or second trimesters of pregnancy).
path of transmission from mother to fetus transplacental called.This path leads to the development of infection complications or perinatal pathology, the severity of which depends on many factors (gestational age, the presence of co-infection, the immune system, etc.).There is also another way of infection by ascending when the virus penetrates the intact shell from infected cervix.
as a factor of transmission is considered biological substrates or body fluids.It may be not only a blood or saliva, and amniotic fluid, breast milk.
order to avoid the negative impact of cytomegalovirus infection, it is recommended to be tested for infection before planning pregnancy.This survey is part of the compulsory survey women.If a pregnant woman was infected directly during pregnancy, the first matter gestational age at the time of infection.In the developing fetus develop lesions in the form blastopaty or embriopaty.There are the following lesions of cytomegalovirus infection:
- blastopatii that arise during infection on day 1-14 of gestation or development.These include the death of the embryo or developing pregnancy, spontaneous abortion, the formation of a rough system diseases (like genetic diseases)
- embryopathy formed during infection at 15-75 days of development.Most often it malformations that result from failure at the cellular and organ level.This can be a pathology of the various body systems (cardiovascular, digestive, respiratory, central nervous system, etc.).Some of these defects may be incompatible with life
While infecting pregnant at a later period of development (after 181 days of development) is formed fetopathy.The consequence of inflammatory reactions in the fetus can be defeat of various organs in the form of hepatitis, encephalitis, pneumonia.At the moment it is very difficult to make an accurate conclusion that it acts damaging way on the developing fetus, for example, the fact that carriers of the virus or exacerbation of infection occurring in a latent form.Congenital cytomegalovirus infection in nature manifested systemic or generalized lesions of various body systems.Congenital viral infection is the development of jaundice, hemorrhagic syndrome, affects the liver, spleen, respiratory and nervous systems.
primary and repeated cytomegalovirus infection during pregnancy
If a pregnant woman infected with CMV for the first time, the risk of infection of the child (congenital CMV) is 30-50%.According to statistics, only ten to fifteen percent of all cases of congenital CMV infection the symptoms observed in children immediately after birth.These symptoms include red patches on the baby's skin, seizures, problems with the liver, spleen, eye.Most of these symptoms disappear within several weeks or months.However, do not underestimate the danger of congenital cytomegalovirus infection: children contracted the virus in the womb may suffer serious consequences from such infections as hearing loss, visual impairment, mental retardation, learning difficulties.In addition, according to statistics, about fifteen percent of women infected with cytomegalovirus during pregnancy leads to abortion.
In the case of re-cytomegalovirus infection during pregnancy, the risk of infecting the baby is much lower - less than 1%.Less than 10% of cases, the symptoms of CMV infection are observed in the child immediately after birth.However, the re-cytomegalovirus infection in pregnant women is not less dangerous than the primary: the virus infected the child in 10-15% of all cases resulting in serious complications such as hearing problems in the child, difficulty in learning.
time CMV infection during pregnancy, as shown by medical research that will not affect the child's risk of infection.
However, be aware that the CMV infection in early pregnancy can lead to more serious consequences of infection for the baby's health in the future.
There is a need for the appointment of treatment
negative impact of cytomegalovirus infection during pregnancy requires a course of therapies.This is due to the fact that pregnancy is characterized by physiological state of immunosuppression.Against this background, there is an exacerbation of viral infection, if a woman is already its carrier.The determining factor for the purpose of therapy is the level of immunoglobulin M, G.
from the second trimester allowed holding of interferon.Method of production of interferon are rectal suppositories.The suppository contains interferon alpha-2 or its combination with a complex dry immunoglobulin preparation.Immunomodulators prescribe a course of ten days, they are administered into the rectum twice a day.If during the dynamic observation was revealed the increase titers of immunoglobulin G, you can recommend intravenous normal human immunoglobulin.Three times during pregnancy in each of the trimesters assigned 2.5 g three times a day.
Against a viral infection is appropriate metabolic therapy.This is a good means of preventing the development of placental insufficiency placental insufficiency - a deviation from the norm , which complicates the development of a viral infection.For this purpose, appointed by the ten-day course of taking the drugs:
- folic acid
prophylactic dose of folic acid is 0.02 g three times a day.In each individual case, the dose should be changed, it can be increased to therapeutic, when it comes to infection during pregnancy.
Appointment courses of metabolic therapy improves metabolic processes in the fetoplacental complex that underlies the prevention of complications (this may be intrauterine fetal hypoxia fetal hypoxia - the consequences of lack of oxygen in the body , fetoplacental insufficiency, growth retardation, and others).Special controls deserve those pregnant women who are at risk for the development of primary CMV infection, so this category of pregnant women should be the control of placental functioning of the system.As still not developed specific prevention of viral infection, it is necessary that the pregnant woman The usual preventive measures, such as compulsory adherence to hygienic measures and personal hygiene.
How to determine whether the virus infected child?
If the fact of cytomegalovirus infection during pregnancy is confirmed, to check for possible infection of the child is carried out ad hoc analysis - amniocentesis amniocentesis for taking on the analysis of amniotic (cavity) fluid.Samples of fluid examined under a microscope for signs of cytomegalovirus.Itself is absolutely safe and amniocentesis to any complications of pregnancy, generally does not result.
In some cases, the symptoms of congenital CMV infection in a child can be determined already in late pregnancy using ultrasound.Ultrasound may show slowing of fetal development is too little head, a violation of the structure of certain brain structures.However, most of the symptoms of CMV infection are manifested in the child after birth - or do not appear at all.
consequences of infection
Cytomegalovirus Infection during pregnancy can cause very serious consequences for the child.Very common lag in growth and development, certain disorders of the liver and spleen (including enlargement of the liver, jaundice).The most severe consequence is considered central nervous system - in this case Cytomegalovirus CMV - what is its danger? can lead to deafness, cerebral palsy, mental retardation Mental retardation - if the mind is underdeveloped child person infected with CMV in the womb.