Pre-natal infection

Description:

Pre-natal infection - the disease of a fruit or the newborn which arose owing to his antenatal or intranatal infection with the causative agent of any infectious disease.

Earlier the term TORCH syndrome was eurysynusic. Now it is applied seldom as it includes only five diseases: toxoplasmosis, syphilis, rubella, Cytomegaloviral infection and herpes.

Now adequate statistical data on pre-natal infections are absent. However there are separate researches indirectly testimonial of considerable prevalence of pre-natal infections. So, on average and at 60-80% of the patients carried to group of high risk in slime from the cervical channel find a cytomegalovirus and a virus of a herpes simplex in 33% of women of childbearing age. Normal vulval microflora is revealed less than at 50% of pregnant women. In the last decade the clear tendency to increase in a share of pre-natal infections in structure of perinatal mortality is traced (mainly due to diagnosis improvement). Infection frequency to some extent depends on an epidemiological situation and is especially high among groups of the population with the low social status.

Symptoms of the Pre-natal infection:

The clinical picture of pre-natal infections significantly depends on time and a way of infection.

- In the first 8-10 weeks of pre-natal development only the alterativny phase of an inflammation is possible, process comes to an end with either death of an embryo, or formation of inborn malformations.

- Later also the proliferative component of an inflammation begins to be shown. Infection on later terms (11-28 weeks) causes growth of connecting fabric (for example, a myocardium fibroelastosis), a dysplasia and a hypoplasia of internals, a delay of pre-natal fetation and generalized infectious processes.

- At infection of a fruit after 28 weeks three components of an inflammation - alterativny, proliferative and vascular participate.

- At the localized forms of pre-natal infections there is a damage of internals (fetalis hepatitis, a hepatolienal syndrome, a cardiomyopathy, intersticial nephrite, pre-natal pneumonia, a coloenteritis, etc.) and TsNS (encephalitis or an encephalomeningitis). Process of formation of a brain of a fruit continues during all pregnancy therefore inborn malformations and defeats of TsNS register considerably more often than pathology of other bodies. As clinical displays of pre-natal infections generally have nonspecific character, "perinatal encephalopathy" or "disturbance of cerebral circulation" in most cases expose the diagnosis.

- The clinical picture at a generalized pre-natal infection reminds sepsis (damage of internals, hemolitic anemia, thrombocytopenia, a hemorrhagic syndrome, insufficiency of adrenal glands, infectious toxicosis).

- Perhaps asymptomatic beginning with the subsequent expansion of a clinical picture (the delayed pathology): a gipertenzionno-gidrotsefalny syndrome, the progressing cataract, a diabetes mellitus, hepatitis, pathology of an urinary system, etc.

Reasons of the Pre-natal infection:

Most often pre-natal infections are caused mixed virus (to 80%) also by virus and bacterial microflora. Also perhaps transplacental infection protozoan diseases (for example, toxoplasmosis, malaria).

    * Antenatal infection of a fruit most often happens transplatsentarno, is more rare through the infected amniotic waters.
          otransplatsentarnym in the way there is an infection with a cytomegalovirus, viruses of a herpes simplex of types 1 and 2, viruses of a rubella, hepatitis B and C, HIV. Among virus associations Koksaki's enteroviruses In or influenza viruses And or With in combination with a virus of a herpes simplex or a cytomegalovirus prevail. Consider that at severe defeat of a fruit not less than three different viruses participate in its infection. For the majority of bacteria and protozoa the placental barrier is impenetrable, however infection can arise at damage of a placenta and formation of chronic fetoplacental insufficiency.
          oinfitsirovaniye amniotic waters comes ascending (at localization of pathological process in a vagina or a neck of uterus), descending (at penetration of the activator from an abdominal cavity through uterine tubes) and contact (at inflammatory process in a uterus and a placenta) way. In similar cases infection not only with viruses, but also mushrooms, bacteria (mainly opportunistic), mycoplasmas, chlamydias is possible. The heaviest, septic, forms of pre-natal infections develop at placenta infection with a contact way from the infected amniotic waters.
    * Intranatal infection is characteristic of herpetic, mycoplasmal and Chlamidia infections. However also intranatal infection with bacteria is possible. In this case representatives of opportunistic gram-negative microflora (intestinal and pyocyanic sticks, a klebsiyella, proteas), staphylococcus and ß - hemolitic streptococci of group B, a gonokokka are causative agents of pre-natal infections more often.

The risk of pre-natal infections is connected not so much with acute infectious diseases during pregnancy how many with existence at future mother of chronic pathology and various complications of pregnancy. Communication of pre-natal infections with existence is not found by a SARS or an aggravation of a herpes infection during pregnancy.

Treatment of the Pre-natal infection:

Treatment at pre-natal infections has to be complex and it is obligatory to include posindromny therapy.
I. Immunotherapy
• Ig:
- Polyvalent
- Specific
• Immunomodulators (interferon)
II. Antiviral therapy (drugs of the directed action)
III. Antibacterial therapy
• Antibiotics of wide
action spectrum
• Macroleads (at Chlamidia
and mycoplasmal infections)