Author of the article - an obstetrician Grigorieva Xenia S.
Ureaplasmosis - urinary tract infectious disease, which has no specific symptoms.
Normally, these bacteria are present in the body of each person, and not harmful, but their excessive multiplication of inflammation occurs.
Some doctors believe that ureaplasmas can cause infection only under certain conditions, however they relate to opportunistic microorganisms. Others call them absolutely pathogenic bacteria, which are the sources of infection process (urethritis, cystitis, endometritis, pyelonephritis, sepsis, pathology of pregnancy, fetus and newborn and so forth.).
Ureaplasmas normally found in 5-15% of healthy women, 45% of pregnant women, 80% of women with inflammatory diseases.
Causes
Pathways ureaplasmosis:
- sexual (through unprotected sexual intercourse);
- upward (in the uterus, fallopian tubes, peritoneal cavity);
- hematogenous (blood-borne);
- transplacental (from mother to fetus through the placenta).
Symptoms and signs
Symptoms ureaplasmosis not possess specificity for a disease characterized by chronic and resistant to antibiotic therapy.
The most common symptoms:
- Itching and burning of the genitals.
- micturition disorders.
- vaginitis (Inflammation of the vagina).
- Inflammation of the mucous layer of the cervical canal (endocervicitis).
Diagnostics
To be diagnosed using these methods:
- The culture method (the most efficient). To investigate the doctor takes a swab of the vagina and urethra, cervix scraping. With this method it is possible to determine the bacteriological ureaplasmas sensitivity to antibiotics (choose which drugs will be more effective).
- Immunological methods. Investigated the blood from the vein to detect specific antibodies.
- PCR method. This diagnostic study to determine ureaplasma DNA in biological material.
Normally, these bacteria can be detected up to 10? CFU / ml without clinical manifestations.
Differential diagnosis should be made with other infectious diseases (by means of laboratory tests).
ureaplasmosis treatment during pregnancy
The goal of treatment is to eliminate waste products and pathogen reduction of symptoms.
Treatment with antibacterial agents is assigned only when the diagnosis is confirmed ureaplasmosis. If clinical signs are absent, and laboratory values below 10? -10? Cfu / ml, the antibiotics are not used.
When pregnancy is assigned to comprehensive treatment, antibiotic therapy is performed in the second trimester (18-22 weeks). Used drugs:
- josamycin;
- erythromycin;
- Spiramycin.
The course of treatment is 10 days.
In one trimester treatment is mainly aimed at preventing placental insufficiency. Appointed by the intravenous immunoglobulin, which is recommended to be repeated in 20-24 weeks and 35-36.
possible complications
As with any other infection, ureaplasmosis can cause complications:
- During pregnancy, especially in the early stages, in the 45-70% compounded threatened miscarriage. When the endometrium (the inner layer of the uterus) and the fertilized egg is infected, there is defective implantation (attachment), which is the cause of spontaneous abortion or preterm birth.
- From 24-26 weeks of pregnancy can be complicated preeclampsia (40-60%). This pathology, in which vital organ function is disturbed. It manifested as high blood pressure, and edema formation protein in the urine.
- polyhydramnios or hypamnion It develops in 13-24% of cases.
- Prenatal ureaplasmosis. It can cause pneumonia in newborns, heart damage, liver and kidney. 30% of children have a central nervous system: hydrocephalus (fluid in the brain), ventriculomegaly (increase brain ventricle size) and others. Also in 30-40% of cases, the fetus may experience malnutrition and chronic hypoxia.
- Chronic endometritis. It is an inflammation of the mucous layer of the uterus, which leads to disruption of the menstrual cycle and infertility.
- Placental insufficiency. This violation of the placenta, which can lead to growth retardation and hypoxia.
The above-mentioned complications can occur if not treated ureaplasmosis during pregnancy, and ideally before it. Remember, all tests that are prescribed by a doctor, you need to take the time. And if any alarming symptoms immediately inform the obstetrician-gynecologist.
Forecast
The prognosis for adequate treatment to the mother and fetus favorable.
Some studies in pregnancy
- Smears during pregnancy.
- Tests during pregnancy by trimester.
- Ultrasound during pregnancy.
- Urinalysis in pregnancy.
- Coagulation.
- Installing pessary.
- Glucose tolerance test.
- Homocysteine in pregnancy.
- Amniocentesis.
- Anesthesia during childbirth.
- Fetal CTG (cardiotocography)
- Cordocentesis.
- Epidural anesthesia during childbirth.
